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Current High-Performance Governance Practices
Board Checklists
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.
Dashboards and Balanced Scorecards
Dashboards/Scorecards
The dashboard or “balanced scorecard” has become a staple of effective governance. Charts and numerical data provide a comprehensive picture of organizational performance. Here are some questions to assess whether your board’s dashboard is as good as it could be.
The Role of the Board in Creating Value Chart
Dashboards/Scorecards
Value creation occurs at many levels in organizations. This chart, used by St. Charles Health System based in Bend, Ore., describes the unique role of governance as well the roles of leadership, management and front-line workers in applying Lean principles to support sustained organizational improvement.
Policy on Board Composition and Recruitment
Board Policies
Governance responsibilities today are so significant that board members must bring more than commitment to the mission and interest in serving. As William Bowen writes, every trustee should bring a “specific competence or experience needed on the board.” This sample provides a board policy statement on competency-based recruitment, election and re-election of board members. Use it to customize a
process for your board.
Board chair coaching process
Discussion Questions & Templates
A good coach focuses on what the board chair wants to accomplish and designs a coaching process based on how the board chair experiences the role; on assessment of individual strengths and weaknesses; and on identifying and addressing blind spots. Each coaching process should be customized to meet the board chair’s individual needs and goals.
The Leadership Audit
Evaluations and Assessments
To understand how the organization really functions on a day-to-day basis, boards need to gauge the hospital’s work life and its efficacy. Board responsibilities include: (a) understanding the hospital’s operating model and whether it actually performs in that mode, how critical decisions are made, and the hospital’s ability to recognize its own problems and “self-correct”; and (b) ensuring that it happens.
Sample Board Demographic/Attribute Profile Matrix
Adapted from “Recruiting for a Diverse Health Care Board,” by Karma H. Bass (Trustee Insights, Dec. 2020).
Decision-making Processes and Tools for Boards
Dashboards/Scorecards
As this grid suggests, good governance decision-making, when supported by a variety of board practices and tools, strengthens the board as a whole and its capacity to govern well.
Seven Techniques to Strengthen Board Decision Making
Evaluations and Assessments
Effective decision making often requires different techniques or approaches for different types of decisions. The following techniques and practices can help support and strengthen your board’s decision-making processes.