QUESTION:        After nearly six long years of service to my Medical Staff, my term as Chief of Staff is nearly over.  Elections will be held in September and I will hand over this role at the end of December.  Are there any steps I should be taking in these final few months to “pass the torch”?

ANSWER:            First off, thank you for your many years of service and kudos to you for anticipating the changing of the guards that is coming up this fall.  While December may feel far away when people are still returning from their summer vacations, the end of the year will arrive sooner than you think.

Based on your statement that you’ve spent six years in leadership, I’m guessing that you automatically became Chief of Staff after serving a term as the Vice Chief and that prior to that, you served a term as the Secretary-Treasurer.  If automatic succession of officers is indeed the practice within your Medical Staff, the good news is that the soon-to-be-Chief has already had some experience in leadership, has likely already been attending MEC meetings and is probably generally “in tune” with the day-to-day functions of the Medical Staff leadership already.  Accordingly, he or she should be better prepared to take over (when compared with, say, a Chief of Staff elected at random and not through succession).

A few tips on how to increase the chances of a successful and seamless transition:

• • Consider the value of leadership education for new leaders. In our experience, many Medical Staff leaders have questions not only about tough credentialing and peer review issues, but also about fundamentals.  Amongst other things, this includes questions about running meetings (e.g., agendas, minutes, recusals, quorums), intervening with a colleague in a way that is collegial and/or friendly but still gets the point across, and legal protections for leaders (e.g., “If I get sued by a doctor, is my malpractice insurer going to cover that?”).

Some hospitals and medical staffs choose to send all new leaders to leadership education within the first year of any term of office (and require it as one of the duties of the office).  Others simply provide education for all leaders on a periodic basis and ask that anyone who is interested attend.  Providing education to both new and seasoned leaders can be helpful and can provide opportunities for leaders of all experience levels to discuss new strategies and develop new policies and procedures at home.

If you don’t already have a leadership education tradition, now may be the time to suggest it – to help the incoming Chief get off on the right foot.

• • Consider one or more meetings with the incoming Chief of Staff, as well as the chairs of the Medical Staff committees that handle most credentialing and peer review matters. These meetings should be focused on preparing the new leaders to take over.  They can provide an opportunity to review issues that are “in process” and likely to require additional follow-up after the transition to new leadership.  Further, leaders can share insights about challenges and successes during the previous leadership term.  If certain Medical Staff members have been difficult to work with, it might be helpful to inform the incoming Chief of that fact – and any hot button issues that are still sizzling.  If certain Medical Staff members have been helpful to you as a leader (for example, by showing a willingness to sit on an ad hoc committee or hearing panel), it can be helpful to relay information about that as well.  Further, if you have come to know about helpful resources or techniques during your term as Chief, now is the time to teach the incoming Chief about those things, so that he or she does not have to recreate the wheel.

• • If you conducted any collegial conversations with a colleague that you did not document, remember to sit down with the incoming Chief of Staff over the next few months to give him or her a “heads up.” That way, if similar concerns arise during their term, they will know that they are not the first to encounter such issues and may need to take a more progressive approach to managing the issue.

• • Consider working intimately with the incoming Chief of Staff over the next few months so that he or she will be fully prepared to step into your shoes in December. Discuss proposed agendas for upcoming meetings, show the Vice Chief how you work with the Medical Staff Office or other support professionals to gather and distribute materials in advance of the meeting (and provide notice of meetings), copy the Vice Chief of important communications and memos related to the job, and invite the Vice Chief to attend meetings, particularly if those meetings will discuss issues that are unlikely to be finalized by the end of the year.  Now is your opportunity to “train” the incoming Chief for the job.  And if he or she can find the time to engage, it will likely make the job of Chief that much easier to tackle when December rolls around.

• • Finally, if the leadership structure at your Hospital does not already formalize the role of the immediate past Chief of Staff, consider whether that would be helpful. Many Medical Staffs utilize the past-Chief on a Leadership Council (a small group of the most involved leaders, which triages complicated clinical peer review issues and directly manages many professionalism and practitioner health concerns).  Others utilize the past-Chief(s) as chairs or members of important committees, such as the Credentials Committee or the multi-specialty peer review committee, thus allowing those committees to benefit not only from the experience, but also the institutional memory, of the past-Chief.  Even if you are not ready to take on another term of leadership after six long years of service, consider making yourself available as an advisor to other leadership bodies on an as-needed basis going forward.  We generally recommend that the Medical Staff Bylaws and related documents acknowledge that the past-Chief will serve as an advisor to other leaders (if for no other reason than to make clear that the past-Chief is entitled to the same immunities as other leaders and his or her actions are covered by the same peer review confidentiality and privilege protections).