Resource Library

Executives, trustees and physicians should be the leading advocates of philanthropy.

Health care governing board members confront a complex and changing financial landscape in their role as stewards of health care organizations. Hospitals and health systems have faced slim bottom lines for an extended period that have reduced available dollars to invest in organizational advancement and forced many to change strategy, forego acquisition of new technology, delay physical plant improvements, reduce services and streamline staff.

This 2014 National Health Care Governance Survey includes many questions from previous surveys that allow insightful comparisons of governance evolution over time. It also probes new areas to enable a better understanding about how hospital and health system boards are preparing for and responding to the transforming health care environment.

This Mind Map, developed in association with innovation partner HDR, depicts a variety of business objectives in healthcare today that are top of mind for healthcare strategists.

With health reform comes increased demand for transparency about organizational performance and accountability. While most hospital and health system senior leaders realize this, board members, surprisingly, may not. As such, boards must have a clear understanding of their accountability to the organization’s stakeholders in order to govern effectively.

A successful governance education process requires commitment, collaboration and consensus. Below is an outline of how a board of trustees may design a process that will ensure optimum development of leadership knowledge and effectiveness...

For boards to participate in shaping their new organization, they must be currently performing at an extremely high level. The following is a list of four practices that hospital and health system boards must be engaged in today, in order to be successful in the future.

Establishing well-organized and consistent governance processes and procedures enables the board to be most productive, and ensures that its time is allocated to the most critical topics. Agendas should reflect the most important strategic issues and priorities, and make efficient use of trustees’ valuable and limited time; meetings should be designed to maximize trustees’ ability to engage in critical dialogue; and committees and task forces should be used to enable the board to focus time on high-level strategic discussion.

Serving on the boards of a hospital system and its health plan offers a unique governance perspective. My journey as a student of governance began 10 years ago when I attended a course on board best practices. As president of the Health Plan Alliance in Irving, Texas, I thought this would be a good way to enhance my communication with my own board, which is made up of C-level health plan executives.

Great health care boards primarily focus on enabling their organizations to create innovative solutions that address community needs for improved health and well-being. They also address regulatory, competitive, resource and other challenges that sometimes may seem daunting, but these do not divert them from their primary purpose.

When someone walks into your hospital, his first impression is created by the physical architecture. But his lasting impression — and what he is most likely to talk about when he returns home — will be determined by what we call the “invisible architecture” of core values, organizational culture and behavioral expectations.

Recruiting board members is a challenge for every hospital and health system, but the task is particularly difficult in small communities. At Benefits Health System, Great Falls, Mont., our pool of candidates is largely limited to the city’s 60,000 residents, despite the fact that we are the tertiary referral center for a population of 250,000 across nearly 40,000 square miles of rural Montana.

Much has been written about the resources that hospitals should provide their board members to develop their governance expertise. Generally, a good orientation to the board’s work, educational sessions at board meetings, an annual retreat, periodic attendance at outside educational programs and frequent performance evaluation are some of the basics for any board.

This monograph addresses the multiple accountabilities of nonprofit health system boards for the cost, quality, and safety of the services their facilities provide, the manner in which these accountabilities are being fulfilled, and issues we believe warrant attention by system leadership in order to retain and build public confidence, respect, and trust.

Although scorecards that measure health system performance against established metrics have become an increasingly common and useful tool in the trustee’s governance toolbox, finding concrete, comprehensive ways to measure how well the organization is achieving its strategic goals — and, in turn, determining incentive compensation based on goal achievement — can be a daunting, ephemeral task. Here’s how one health care system has successfully connected all the dots.

Steps CEOs and boards should take to understand and improve engagement.

As hospitals buy physician practices, board compensation oversight must shift into high gear.

With CEO support and opportunities for education, trustees can become better hospital leaders

A 2012 study of Governance Practices in an Era of Health Care Transformation conducted by AHA’s Center for Healthcare Governance found that work to create greater value is where hospitals and systems in the study— and their governing boards—are spending most of their time. According to study findings, participating organizations “are concentrating on the nuts and bolts of… reducing costs and improving care quality.” The work is wide-ranging and intensive: