January 26, 2024

A Checklist to Ensure a Successful Transition as a Healthcare Executive

Leadership Development

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When transitioning to a new healthcare executive role, you have a critical time window to ramp up your knowledge of the organization, build relationships, shape perceptions and even your reputation. That’s especially true when you’re also new to the organization or system.

In our experience coaching executive leaders in transition, our clients have found it helpful to break down their transition experience into the components outlined below. We’ve compiled critical areas into a checklist for a successful transition. 

Our goal is to get you asking the right questions so your best intentions aren’t derailed by daily distractions that will surely compete for your attention.

Understanding the ORGANIZATION

▷ Create your listening and learning tour:

  • Develop a communication and transition plan based on what you’ve heard and what you will focus on for the first 90 days, and then beyond. Get help with this: Ask which stakeholders you should be meeting with and how to prioritize them. Building trust needs to be a first priority.
  • Ask the following questions, consistently, from each audience. Consistent questions reveal themes. Also ask follow-up questions for clarification in each of these categories so you know what is helpful for physicians versus nurses or administrators, for instance. Don’t forget to take notes and refer to them often as you continue your transition.
    • “What are we doing today that you’d say is helpful and should continue?”
    • “What are we doing today that you’d like us to stop because it’s frustrating, bureaucratic, and not helpful?”
    • “What aren’t we doing today that we should be doing?”

Other key conversations with your peers and leader:

  • Teach them how to work with you in areas such as:
    • What inspires you about your work
    • Your leadership philosophy
    • What you look like under stress
    • How to communicate with you
    • Your pet peeves
    • Your behavioral/leadership expectations
  • Ask questions such as:
    • What inspires you about your work?
    • What do you look like under stress?
    • What are your pet peeves?
    • What do you need from me to support you in your work?
    • What key relationships do I need to develop and grow within the organization?
    • What are the sacred cows that exist in the organization?
  • Think about what you might need from them and ask for it.
    • Should we schedule regular meetings?
    • What would be the best cadence?

Identify the individuals who will help you navigate (a) the organization and (b) its politics:

  • What key relationships do you need to build and why? Consider internal stakeholders, system leaders, board of directors, community partners and other relationships critical to your success.
  • How will you build these relationships?
  • Who might you rely on for introductions? How can you leverage referent power to build trust quickly?

Learn the culture of the organization by asking these questions of your teams and peers:

  • How would you describe the culture of the organization?
  • What are the key behaviors you see that help us be successful?
  • What are the behaviors you see that get in the way of our success?

Understanding and developing your TEAM

Know and shape the culture of your team

  • How will you bring your team together in a hybrid/virtual world (if applicable)?
  • What are your boundaries and expectations of your team? How will you communicate with them?
  • How will you get to know their worries, challenges, barriers, wants, needs, aspirations? (We recommend Personal Management Interviews, or PMIs, as outlined here.)
  • How will you learn their backgrounds, strengths, skills?
  • How will you help them understand your communication style and get to know theirs? (Use your assessments and teach them how to work with you — what you look like under stress, your pet peeves, what inspires you about your work.)
  • Ask them how you can help them with (a) their work, (b) their growth, and (c) removing barriers.
  • Define your meeting cadence, both individually and collectively.
  • Ask how they work currently as a team. What are the behaviors that may be getting in their way? What could they do differently to become a high-performing team?


▷ What are the strategic priorities of the organization

  • What is the Vision and Mission of the Organization?  
  • Does your department or division have strategic priorities already defined? How do they fit into the broader organization priorities and help achieve the Vision and Mission?
  • What is the progress on the existing priorities?
  • What are the expectations for you to shift or reprioritize?

▷ What are your priorities?

  • What are the key priorities for you?
  • What are the timelines and expectations around priorities you’re responsible for?
  • How do you communicate progress, barriers, delays?
  • How do they connect to the Vision/Mission of the organization?

Understanding the HISTORY

Understanding the organization’s history is important! It will help you discern what has worked, what hasn’t, and why. It will help you dodge landmines and frame any stated resistance as an opportunity to learn.

  • Seek insights from your colleagues, yet pay attention to their speed of change. Is it the right speed?
  • Stay open minded to what can be sustained, yet understand what needs to change.

Managing CHANGE 

Plan for how you will drive change, taking care to build psychological safety.

  • Learn the SCARF framework to mitigate neurological threats. Put simply, SCARF stands for 5 key domains of social experience that impact workplace performance. They’re helpful in understanding the impact of past experiences, deciding how you communicate and planning for change.
    • Status: Each person’s perceived importance in relation to others.
    • Certainty: Ability to predict the future.
    • Autonomy: Choice and sense of control.
    • Relatedness: Sense of belonging.
    • Fairness: Perception of fair treatment among team members.

CEO Alignment

Clarify your CEO’s or Boss’s expectations, priorities, preferences, timelines.

  • What are his/her pet peeves, and how does he/she act under stress?
  • What support will you need from him/her?
  • What does he/she need from you?
  • What are his/her communication expectations?
  • What keeps him/her up at night?

Thriving in your transition

Your careful consideration of the questions we’ve raised here will put you in a position of considerable advantage as you settle into your new role. Keep in mind, you don’t have to “go it alone” — we know how tricky it can be to share misgivings with your new coworkers. 
If you’d like some help clarifying next steps, we’re happy to point you in the right direction and discuss whether healthcare executive coaching is right for you. Get in touch and let us know how we can help.

Need help navigating change or growing your impact as a leader?

Healthcare leaders choose MEDI Leadership for our unmatched breadth of expertise, and the results to match. The nation’s only coaching firm focused exclusively on leaders in healthcare, MEDI Leadership coaches have rich industry experience and a long record of helping leaders create meaningful change. Our methods, customized to individual goals, are rooted in solid research on how humans are wired to learn and change, and behaviors needed to drive lasting transformation in complex environments and shifting conditions.

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About the author

Cheryl Foss, MSW

Cheryl Foss, MSW, a MEDI Executive Coach, has over 20 years of Leadership Development, Team Development, Strategy Development, Organization Design, and Change Management experience.

Amy King

With decades of HR consulting and leadership coaching under her belt, Amy has a deep understanding of the behaviors and dynamics that drive culture, influence, and performance in organizations. Those who’ve worked with Amy know her as an authentic, thoughtful problem-solver, equipping leaders to thrive and build high-performing teams. Her coaching style is rooted in core values, helping leaders clarify their purpose and inspired future.

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