Are Hospitals and Health Systems Overly Reliant on Community Boards for Community/Consumer Engagement?

By Luanne R. Stout

Traditional community-based boards in health systems and hospitals have long been the stalwart of health care governance because of their value in connecting health care organizations to the communities they serve. While community boards continue to provide significant value, these board alone may not be sufficient to create the level of community connection hospitals and health systems need in an increasingly complex environment. As some health systems streamline their governance structures, and communities and their needs become more diverse, health care organizations can benefit from adopting a number of mechanisms to further broaden community engagement and advance philanthropy.

Why Hospital or Health System Boards Are Not Enough for Consumer or Community Engagement

It is important to understand why hospital or system boards alone may not be enough. In non-profit organizations members of these boards typically serve on behalf of constituents who have a significant stake in the organization’s performance and success. These boards have generally been – and continue to be – largely comprised of business and community leaders, along with a handful of other stakeholders (e.g., physicians, religious sponsors, etc.), selected to be a voice for community needs and an advocate for the organization.

It is unlikely that health systems and hospitals can create and maintain governing boards that speak for all segments of the community. Even if the goal were set to create a membership that proportionally reflects the community’s age, gender, ethnic, racial, industry, political, economic and thought diversity, and includes community leadership and competencies that best support the board’s work, most boards would not be able to meet all these goals at once. The American Hospital Association’s 2014 National Health Care Governance Survey and studies by other leading governance organizations over the past three years indicate the majority of hospital and health system boards continue to have insufficient diversity. While the field acknowledges there is work to do to expand the diversity of board membership, boards themselves will continue to have size and other limitations that prevent them from being all things to all people.

As health care continues its journey to reshape the way care is delivered, there also is a growing realization that communities are not based simply on individuals’ socio-economic position, ethnicity, race, districts, language spoken or the myriad of other factors that make up the melting pot of American society. There are communities within communities and perhaps thousands of interacting factors that influence health care decision-making beyond any given census criteria.

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