Succession planning in nursing management: a scoping review

Abstract

Objective

The aim of this review article is to comprehensively examine and analyse the studies and research conducted in the field of succession planning in nursing management.

Introduction

Succession planning, through the identification and appointment of qualified managers to key leadership positions, helps improve the quality of nursing services.

Methods

The present study is a scoping review that was conducted using Arksey and O’Malley’s framework. We used English-language databases such as Web of Science, PubMed, Scopus, ProQuest and the Google Scholar search engine. Additionally, for searching Persian-language sources, databases such as the Islamic World Science Citation Center, the Jihad University Journals Bank, Iran-Doc, Elm-Net and the Ministry of Health’s of Iran Theses System were employed.

Results

30 documents were selected based on the evaluation for data extraction, aligning with the objectives of the study. The results of the data analysis identified six main categories related to succession planning: barriers, facilitators, requirements, contextualisation, cyclical succession planning and potential succession planner organisation.

Conclusion

Based on the importance of succession planning in nursing management, we recommend using the study’s findings to plan and carry out thorough and practical research, formulate guidelines and managerial policies, define hospital goals and missions, and shape the organisational vision.

WHAT IS ALREADY KNOWN ON THIS TOPIC

• Given the neglect of succession planning in nursing management, it is important to address the factors that contribute to a proper understanding and accurate perception of this concept.

WHAT THIS STUDY ADDS

• This study used the scoping review method to examine succession planning status in nursing management. This study used Arksey and O’Malley’s framework to review the available evidence. This study attempted to select articles using a coherent search method and within a reliable time range, given the limited availability of relevant resources. The paucity and uncertainty of some of the results in the evidence may have limited the scope of some of the implications as we attempted to select the most rigorous articles for review.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

• Succession planning can aid in achieving scientific methods for identifying, developing and replacing talented managers for organisational positions.

Introduction

Succession planning in nursing management has been recognised as a key factor in ensuring the sustainability and progress of healthcare organisations.¹ The alignment of nursing with daily needs and global advancements, along with the presence of competent and qualified nurse managers, is an important issue. The key goal of succession planning in nursing management is to prepare and nurture a capable and talented workforce to meet future staffing demands.² By establishing a comprehensive and organised succession planning programme, managers can ensure the availability of a strong pool of human resources with the necessary abilities and skills to address future challenges. This is achieved through the identification, recruitment, training and development of young and capable nurses.³ Succession planning in nursing is essential for formulating important organisational strategies and delivering quality services.⁴ Healthcare organisations have always been the focus of attention. With demographic changes in societies and an increased emphasis on community health and healthcare needs, ensuring the presence of skilled and specialised nurses in the healthcare system is essential and imperative.⁵ The main goal of succession planning in nursing management is to equip and cultivate a skilled and capable workforce to address future staffing requirements. By creating a well-rounded and systematic succession planning programme, managers can secure a solid pool of talent equipped with the essential skills and abilities to face future challenges.⁶ However, succession planning has not yet received sufficient attention from healthcare organisations.⁷ Given the changes occurring in healthcare systems, the increasing demand for caregivers and the complexity of services, there is a need to identify and train competent managers to oversee and address management issues in nursing; succession planning, through the identification and appointment of qualified managers to key leadership positions, helps improve the quality of nursing services.⁸ Furthermore, succession planning allows for the preservation of human capital and competent managers within the organisation.⁹ However, the field of nursing faces unique challenges in implementing effective succession planning strategies.¹⁰ Some of the major challenges of succession planning include the lack of necessary policymaking, the retirement of managers, the relocation of managers from their current positions, individuals’ reluctance to accept managerial positions and the absence of well-established mechanisms for succession planning.¹¹

Objectives

By examining the existing literature and drawing insights from real-world experiences, this review provides valuable guidance for nursing leaders, administrators and policymakers in developing robust succession planning programmes that ensure a seamless transition of leadership. The aim of this review article is to comprehensively examine and analyse the studies and research conducted in the field of succession planning in nursing management.

Methods

Design

This study used a scoping review methodology based on the framework proposed by Arksey and O’Malley, which comprised six stages: identifying the research question, identifying relevant studies, selecting relevant studies, charting and categorising key findings (study location, population, objectives, findings and results), synthesising, summarising and reporting the findings, and finally expert consultation.

Research question

‘What are the causes and basic concepts related to succession in nursing management?’

Search in databases

The assistance of two experts in informatics and medical librarianship (MSM and TS) was sought to aid in the search for evidence. The keywords employed in this search encompassed terms such as “succession,” “succession planning,” “career ladder,” “career development,” “career planning,” “staff development,” “career mapping,” “nurse,” “personnel nursing,” “nursing personnel,” “registered nurses,” “nurses registered,” “nurse administrators,” “mentoring,” “theories,” “models” and “framework.” English-language databases, including Web of Science (WOS), PubMed, Scopus, ProQuest and the Google Scholar search engine, were used (online supplemental table S1). Additionally, for searching Persian-language sources, databases such as the Islamic World Science Citation Center, the Scientific Information Database (SID), Iran-Doc, Elm-Net and the Ministry of Health were used. The reason for simultaneous English and Persian was that studying sources in different languages can help a deeper understanding of global and local topics and trends in the field in question. In order to compare the concept of succession planning in nursing management in Iran with the concepts of other studies worldwide, we considered the contexts affecting it. To ensure comprehensive coverage of evidence, searches were conducted across various sources. The search timeframe encompassed the past 15 years, from 2008 to 2023. It should be noted that the reason for selecting this specific timeframe is that a significant amount of time has not elapsed since the introduction of the issue of succession planning in nursing management and the healthcare system in our country. Boolean operators “OR,” “AND” and “NOT” were used in the precise search for evidence. The number of search sources and the corresponding number of retrieved resources are as follows: PubMed (1559 resources), Scopus (823 resources), WOS (944 resources), ProQuest (89 resources) and Google Scholar (58 resources). In Persian databases, a total of 59 resources were found.

Inclusion and exclusion criteria

In this study, based on the Population, Concept and Context framework, the population consisted of nursing managers and nurses. The concept of interest included succession planning, and the context involved nursing management. In order to select relevant studies, the research team established criteria for study inclusion based on the research question. The inclusion criteria consisted of evidence from the past 15 years (the purpose of choosing these inclusion criteria was that the main texts related to succession planning in the field of nursing are limited to this timeframe), studies in English and Persian languages, and non-review research studies related to succession planning in clinical nursing management. The exclusion criteria included duplicate studies, non-English and non-Persian studies, conference papers and proceedings, review studies and low-quality articles (in this systematic review, articles with incomplete information refer to those that, for various reasons, do not provide sufficient data or details for an accurate evaluation of the research). These reasons may include incomplete reporting of results, insufficient explanation of methodologies and a lack of adequate statistical data, books and grey literature (theses and letters to the editor, etc). The most important reason for not using grey studies in this research is the challenge related to the lack of qualitative and scientific stability of those studies, whose findings did not guarantee citation, and unrelated studies.

Data screen

The initial screening of studies was conducted by two individuals (MM and TS). Initially, the titles and abstracts of the studies were reviewed to determine their relevance, and they were classified into two categories: fully relevant and irrelevant. Studies in the second category were eliminated. Researchers independently evaluated the studies and selected the fully relevant evidence. To address potential ambiguities and inconsistencies regarding the selected studies, researchers held a virtual session to resolve any issues. All stages of review and search strategies in scientific databases were documented and stored. EndNote X10 was used to store the reviewed resources and remove duplicate entries.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart

In the present study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram was used to guide the selection of studies at all stages of the research process. Through this approach, the necessary studies for the scoping review were identified (online supplemental figure S1).

Data extraction

During this stage, a table was designed to capture essential information, including the study title, country, study methodology, participant count, data collection method and findings (the final studies meant those that had a direct relationship) to extract pertinent information (online supplemental table S1).^{10 12–40}

Data synthesis

The inductive coding data analysis followed a comprehensive three-step synthesis method, as described by Barnett et al (2009).⁴¹ Initial coding: In the initial step, data were coded line by line using an open-coding approach. Key concepts were selected from the findings section for coding purposes. This included identifying meaningful segments of text and assigning initial codes. Categorisation: In the next step, the initial codes were categorised into descriptive categories or clusters that represented broader similar concepts. Subcategories were then created using these codes. The subcategories underwent evaluation for transparency, consistency and topic comprehension by two researchers (TS and MA-F). Integration of findings: To integrate qualitative and quantitative findings, quantitative results from the studies were first extracted and then converted into qualitative statements, omitting all numerical data. These statements were subsequently coded qualitatively, ensuring alignment with the qualitative data. Similarities between qualitative and quantitative findings were analysed, and results were grouped into corresponding categories. In the final step, obtained subcategories were organised into main categories. This involved a thorough qualitative analysis and synthesis of the findings using an open-coding approach. Concepts derived from the selected study findings were classified based on thematic similarities. All identified factors from the studies were considered open codes and classified under relevant subcategories, forming the main categories. Microsoft Word 2016 was used for tabulating and organising the data effectively.

Results

Numerical results

A total of 3532 studies were obtained during the conducted search. After reviewing the duplicate studies, 2037 cases were excluded. Subsequently, we conducted an initial assessment of 1495 studies based on their titles and abstracts. Out of these, 1310 studies that were deemed irrelevant were excluded from the review process. Next, 185 eligible studies underwent evaluation; however, nine studies were removed from our review due to the unavailability of the full text. Among the remaining 176 studies, which met the required quality criteria for review, 10 were theses (lack of full access), 13 were review articles, 21 were conference papers, 10 were books, 24 were low-quality articles (lacking sufficient information), 9 were unrelated studies and 59 were grey literature (annual reports, technical reports and research reports). All of these were excluded from the review process. In the end, 30 documents were selected based on the evaluation for data extraction, aligning with the objectives of the study.

Synthesis results

According to the analysis conducted in this study, the majority of participants and samples in the selected studies were comprised of clinical nurses, nursing managers and healthcare system managers. The results of the data analysis identified six main categories related to succession planning: barriers, facilitators, requirements, contextualisation, cyclical succession planning and potential succession planner organisation (table 1).

Table 1. Concepts, subcategories and main categories derived from data integration.

Main categories	Subcategories	Concepts
Barriers	Lack of acceptance by nursing management	Resistance to change Lack of executive backing
	Inhibiting organisational factors	Restrictive organisational culture Inefficient processes
	Inappropriate transfer of managers	Ineffective transition Unsuitable appointments
Facilitators	Supporting factors	Developmental programmes Mentorship opportunities
	Positive view of managers	Leadership trust Managerial encouragement
Requirements	Necessities of implementing succession planning	Organisational commitment Training programmes
	Planning	Goal setting Action plans
Contextualisation	Succession planning team	Team collaboration Strategic oversight
	Culturalisation	Shared norms Cultural alignment
	Stakeholder participation	Collaborative input Stakeholder buy-in
	Implementation of succession planning	Execution framework Milestone tracking
Cyclical succession planning	Determining the management capacities of the organisation	Leadership potential Resource analysis
	Competency criteria for managers	Leadership qualities Assessment metrics
	Empowerment/improvement of elected officials	Skill enhancement Leadership training
	Succession planning mentoring	Coaching initiatives Mentorship networks
	Evaluation	Performance review Outcome analysis
Potential succession planner organisation	Progressive organisation	Innovation-driven Growth-oriented
	Consequences of implementing succession planning	Organisational stability Enhanced productivity

Barriers

The results demonstrated that the nature and structure of nursing management may occasionally impede the implementation of succession planning. Moreover, issues associated with organisational constraints can serve as inhibiting factors in relation to succession planning in nursing. Another barrier to executing succession planning in nursing management is the displacement and improper transfer of managers. Specifically, the subcategory of lack of acceptance by nursing management encompasses concepts like resistance to change and lack of executive backing, where entrenched leadership may view succession planning as a threat to their authority, leading to delayed initiatives or insufficient support for talent development. For instance, in high-turnover environments, this resistance can manifest as reluctance to invest in training programmes, resulting in knowledge gaps and reduced service quality. Implications include higher staff attrition and disrupted patient care continuity; options for subcategories involve gradual cultural shifts through awareness workshops or incentivising executives with performance metrics tied to leadership development. Inhibiting organisational factors include restrictive organisational culture and inefficient processes, such as rigid hierarchies that limit cross-departmental collaboration or outdated policies that fail to allocate budgets for mentorship. These can appear in resource-limited settings where administrative burdens overshadow strategic planning, leading to missed opportunities for identifying potential leaders. The practical value lies in recognising how these factors exacerbate nursing shortages; readers can consider options like process audits to streamline workflows or fostering inclusive cultures via team-building activities to mitigate inefficiencies. Inappropriate transfer of managers covers ineffective transitions and unsuitable appointments, often due to hasty decisions without competency assessments, causing role mismatches and organisational instability. Examples include appointing underprepared individuals to key roles, which can increase error rates in clinical oversight. Implications extend to lowered morale and patient safety risks; subcategory options include standardised transition protocols, such as phased handovers with shadowing periods, to ensure smoother knowledge transfer and better alignment with organisational needs.

Facilitators

Based on the findings of this study, the facilitating factors for implementing succession planning include supportive factors and environmental factors as important facilitators that provide favourable conditions for the implementation of succession planning. Managing conditions, supporting talent identification and promoting employee satisfaction and the enthusiasm of current managers, as well as their belief in succession planning, are important issues in the process of identifying and developing deserving managers. The subcategory of supporting factors involves developmental programmes and mentorship opportunities, where structured training initiatives build skills like decision-making and conflict resolution among emerging leaders. For example, in collaborative healthcare teams, these programmes can accelerate career progression by pairing novices with experienced mentors, enhancing overall leadership depth. Implications include improved staff engagement and retention; options for this subcategory encompass integrating mentorship into routine evaluations or creating digital platforms for ongoing skill-building to maximise accessibility. A positive view of managers includes leadership trust and managerial encouragement, fostering an environment where leaders actively endorse succession efforts, such as through public recognition of high-potential staff. This can manifest in settings with strong team dynamics, boosting motivation and innovation. The value for practice is in creating a supportive ecosystem that reduces burnout; readers might explore options like leadership forums or incentive systems that reward managers for nurturing talent, ensuring sustained enthusiasm and belief in the process.

Requirements

The results of the data analysis in this study revealed the presence of strategies and implementation requirements for succession planning. To achieve this, attention should be given to developing a plan and organising for the implementation of succession planning. Succession planning strategy as a subcategory includes talent pipeline and leadership development, requiring systematic identification of key positions and potential candidates through assessments like competency mapping. In nursing contexts, this might involve forecasting retirements and preparing backups, ensuring no disruptions in care delivery. Implications are enhanced organisational resilience; options include annual talent reviews or cross-training programmes to build a robust pipeline. Necessities of implementing succession planning cover organisational commitment and training programmes, emphasising dedicated resources like budgets for workshops on leadership ethics and clinical management. Examples include mandatory participation in development courses to address skill gaps. Practical value lies in aligning with hospital goals; subcategory options could involve policy mandates for commitment or blended learning (online and in-person) to accommodate shift work.

Contextualisation

In terms of creating a supportive environment for succession planning, organisations need to ensure the existence of a succession planning team. Furthermore, to promote the values of succession planning within the organisation, cultural change should be initiated. As part of the facilitation process, the involvement of stakeholders in the implementation of the succession planning programme is considered necessary, ultimately leading to the successful execution of succession planning. The subcategory of succession planning team involves team collaboration and strategic oversight, where multidisciplinary groups oversee programme design and monitoring. In diverse nursing units, this can integrate perspectives from clinical and administrative staff, improving buy-in. Implications include cohesive implementation; options comprise forming dedicated committees or using tools like SWOT (To examine and identify the organization's opportunities, threats, strengths, and weaknesses in the field of succession planning) analyses for oversight. Culturalisation includes shared norms and cultural alignment, promoting values like continuous learning through organisational narratives and policies. Examples are embedding succession into mission statements; the value for readers is in fostering long-term adoption, with options like cultural audits or training sessions to align norms. Stakeholder participation covers collaborative input and buy-in, engaging nurses, managers and executives in decision-making. This enhances relevance; implications are reduced resistance with options such as focus groups or feedback loops for inclusive input.

Cyclical succession planning

The findings indicated that succession planning in nursing management follows a cyclical pattern, focusing on determining the organisation’s management capacity and establishing competency criteria for individuals. Additionally, it is crucial to identify and develop competent individuals through empowerment and development programmes. Another important aspect is the implementation of mentoring in succession planning, which appears to be the key solution in nursing management. Lastly, through the evaluation and monitoring of the succession planning programme and its trajectory, the level of success in the organisation will be closely monitored. Determining the management capacities of the organisation includes leadership potential and resource analysis, assessing current gaps via tools like capacity audits. In healthcare, this identifies bottlenecks like skill shortages; implications are proactive planning, with options such as data-driven forecasts or scenario modelling. Competency criteria for managers cover leadership qualities and assessment metrics, defining standards like emotional intelligence and clinical expertise. Examples include rubric-based evaluations; value is in fair selection, with options like 360° feedback for metrics. Empowerment/improvement of elected officials involves skill enhancement and leadership training through targeted programmes like simulations. Implications include stronger leaders; options encompass personalised development plans or peer coaching. Succession planning mentoring includes coaching initiatives and mentorship networks, pairing mentors with mentees for knowledge transfer. In nursing, this builds confidence; options like formal networks or virtual platforms enhance accessibility. Evaluation covers performance review and outcome analysis, using KPIs like retention rates. Implications are continuous improvement; options include regular audits or adaptive metrics for monitoring.

Potential succession planner organisation

Another significant outcome of this study was the observed dynamism in executing succession planning in nursing management. The implementation of succession planning not only contributes to the growth, development and advancement of the organisation but also yields numerous positive outcomes in achieving organisational goals and ensuring the continuity of nursing management. Progressive organisation as a subcategory includes innovation-driven and growth-oriented approaches, encouraging adaptive strategies like integrating technology in leadership roles. In evolving healthcare systems, this fosters agility; the implications are sustained competitiveness, with options such as innovation labs or growth metrics tied to performance. Consequences of implementing succession planning cover organisational stability and enhanced productivity, leading to outcomes like reduced turnover and improved patient satisfaction. Examples include seamless transitions post-retirement; practical value is in measurable benefits, with options like outcome tracking dashboards or case studies for benchmarking stability.

Discussion

In this study, articles and evidence related to the concept of succession planning in nursing management were analysed. The main findings obtained in this study included barriers, facilitators, requirements, contextualisation, cyclical succession planning and organisational potential in succession planning. The results of this study demonstrate the presence of barriers to implementing succession planning in nursing management, which impedes the selection of competent individuals and capable managers for leadership roles. Based on existing studies, succession planning is associated with notable obstacles, including inadequate financial support and insufficient budget allocation.^{1 12} Weaknesses in training, the absence of organisational strategies, managerial resistance to the inclusion of new and competent individuals and organisational constraints are among the primary barriers to successful succession planning in nursing management.^{13 16} The uncertainty surrounding the future of nursing management for current managers can hinder the implementation of succession planning.^{20 26} Sometimes, managers may be reluctant to create trouble for themselves due to envy and competition, thus avoiding the pursuit of succession planning. They are unwilling to relinquish their own positions.^30–33 Additionally, organisational issues can impact the implementation of succession planning.^{39 40} For example, employees may lack interest in taking on leadership roles, and formal organisational relationships, lack of support from managers and negative attitudes of managers towards succession planning can hinder the process of talent identification and development.^{23 25–28} In a health organisation, it is necessary to have a strategy in place for implementing succession planning, and this should be reflected in the organisation’s plans and vision. In succession planning for nursing management, a cohesive strategy and precise planning are essential for transferring knowledge and skills to future generations, ensuring the continuity of high-quality nursing services.^{10 14–16} An effective strategy in succession planning for nursing management not only helps identify and nurture talent but also fosters a culture of continuous learning and enhances service quality. Succession planning requires support from top-level managers and should be considered a mandatory requirement and a priority within the organisation.^{17 34 36} To have a good succession planning programme in nursing management, it is essential to allocate a sufficient budget and create the necessary motivation and enthusiasm among employees to participate in this programme.^{18 19} It is advisable for the organisation to design a dedicated succession planning pathway.^{24 25} Through this approach, by identifying positions and considering eligible individuals, deserving individuals can be trained and developed, preparing them for key managerial positions. Based on the results of this study, it is crucial to establish a culture that promotes succession planning. In other words, cultural challenges within the organisation, including a lack of awareness about succession planning and the need for a better understanding of this concept in nursing management, should be addressed.^{14 15 37 40} Expanding the concept of succession planning and integrating it into the organisational culture can serve as a crucial facilitator, alongside the positive mindset of managers and supportive factors in succession planning management. Managers should always remember that the precise implementation of succession planning in nursing management will improve the quality of nursing services. The important limitation in this study was the choice of timeframe and the possibility of some studies being neglected. The research team chose a reasonable time domain to overcome this limitation.

Conclusion

A review of previous studies in this research revealed that succession planning poses a significant managerial challenge in nursing. It is crucial for nursing managers to prioritise understanding the barriers, facilitators, underlying factors and related aspects of succession planning in nursing management. The findings of this study can be used to develop a programme and establish a clear and appropriate pathway for identifying, selecting, developing, training and appointing competent managers in key nursing positions. To ensure accurate and effective succession planning, attention should be directed towards policymaking and its implementation within the organisation. Therefore, it is recommended to use the findings of this study in planning and executing extensive and practical research, formulating guidelines and managerial policies, defining hospital goals and missions, and shaping the organisational vision, all based on the significance of succession planning in nursing management. Diligent efforts should be made in this regard.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.