David O’Brien of Alaska Cancer Registry on Succession Planning


Even cancer registries need to have a succession plan in place.

You are a cancer registry manager, and your data analyst of 24 years tells you they are planning on retiring. They do quite a lot of different tasks for the registry, such as processing incoming data files, and performing a myriad of file linkages (such as Virtual Pooled Registry, state mortality, SSDI, NDI, IHS, and the state breast and cervical screening program), installs cancer software, conducts database deduplication, runs GenEdits, generates state statistics, processes and sends the Call For Data file, conducts cancer studies for communities with concerns about pollution and illnesses, among other things. They’ve developed routines and systems for all these tasks, and you have no idea what they are. What are you going to do?

This is exactly what is happening in our registry in Alaska with my planned retirement. Change is always a constant in any cancer registry, and even long-timers like me eventually move on. This is why succession planning is such an important subject. Registries should be prepared for changes in staff with as little disruption of operations as possible.

3-Legged Stool Approach

In Alaska, we are using the “3-Legged Stool” approach to succession planning for my position. Maybe you haven’t heard of this model before? That’s because I just made it up. This is how the model works:

Advanced Notice

This is the seat of the stool since if you don’t have this part, you don’t have anything to which to attach the legs. Once the staff member knows they are leaving, they should give as much advance notice to their supervisor as is practicable. If you don’t get enough advanced notice, then you don’t have enough time to accomplish the next three tasks. In my case, I was the only person in the registry who did data processing and analysis, so I had a lot of information to pass on. I decided to give my supervisor an entire year’s notice so they could start planning early. Admittedly this is unusual, and I imagine the majority of employees give a standard two-week notice. But the longer the period of advanced notice, the better chance you have of creating and attaching the three legs.

Document All Tasks in Great Detail

All our registries are required to have an Operations and Procedures manual. They are very helpful, especially to new staff. But they are usually not cookbooks, just a general outline of processes. That’s why it’s very important for the person who is leaving to take the time to document all the tasks they do using a lot of detail. In my situation, the tasks I perform are often rather complicated, so I decided to start documenting them about two decades ago so I wouldn’t forget how to do them. The way I do these tasks often changes due to advances in technology or updates in the data, so I have to constantly update the documentation to keep it current. I have a master task document that briefly lists the tasks I do each week, each month, and then for each month of the year. For each task, I have a link to a separate document that describes how to do each of those tasks.

Hire a Successor Before Employment Separation

If a successor can be hired before the staff member leaves, then the new staff member can get some great hands-on experience right from the source. This “double fill” hire situation can often be difficult to accomplish. It is more often the case that the position is not filled until the staff member has already left. Some states may have special rules that prevent the previous staff member from being hired as a contractor to train the successor, especially when the previous staff member is receiving a state pension.

Train Coworkers

This final leg of the stool is especially important if it doesn’t look like a “double fill” hire situation is going to happen. The staff member who is leaving can train coworkers or (in my case) colleagues who don’t work in the cancer registry but work in the same section as the cancer registry and have availability to perform cancer registry tasks. And if there wasn’t a lot of overlap between the incoming and outgoing staff member or no overlap at all, the trained staff members can help the new staff learn their job. I hope you find this “3-Legged Stool” approach to succession planning helpful in maintaining the operation your registry in the midst of change.

In 2023, ACR received the Gold Standard for cancer data collected for the diagnosis year 2020 from NAACCR. Visit our resources to see more of our work with NAACCR.

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