This is a non-final version of an article published in final form in The Health Care Manager, Vol. 32, Issue 3, July/September 2013.


A study was conducted to revisit the perceptions of chief executive officers (CEOs) in United States (U.S.) hospitals regarding the origin of leadership and how they felt about internally developed successors versus externally recruited successors. Furthermore, the study sought to understand how this group of executives utilizes the succession planning process, what factors impact successor identification, what positions are applicable for succession planning activities, and who is ultimately held responsible for leadership continuity within the hospital industry. The results of this 2012 study were compared to a previous study conducted in 2007 to determine if the perceptions had changed over time.