Table of Contents



8 Cover Story

Cyber Crisis

While computing technology has become thousands of times more powerful, our methods of securing it have not kept pace. We are seeing more cyberthreats driven by organized crime, hackitivists and nation-state attackers. | Chris Williams


12 Governance

A Whole New System

Integrated hospitals and health care systems hope to achieve the benefits of scale in efficiency, quality and scope. A clearly defined governance structure, often including a system board and local boards, is essential to success of organizationwide transformation. | Jeff Jones


13 Strategic Planning

2017 AHA Environmental Scan

A valuable tool to guide strategic discussions among hospital and health care system boards and executives, this year’s AHA Environmental Scan describes trends that will impact health care organizations in the coming year and beyond.




2 From the Editor

The key goal or Trustee is to provide useful information practical tools for hospital board members to better understand and respond to the many changes happening in health care today.


3 Update

A shooting in a Florida hospital killed a patient and employee, but because the organization had an active-shooter plan in place, police say even more deaths were averted. All hospitals should consider these steps to prevent should tragedies.



Hospitals must find and engage partners in their communities to transform health care and build a “culture of health.” Here are five key areas to concentrate on to make your effort successful.



6 Partnerships

Hospitals, health systems and clinics are developing strategic partnerships to better serve their communities’ health needs. Understanding and resolving potential conflicts in governance cultures is an important factor in successfully implementing those partnerships.


Quality Measurement

27 Executive Briefing

Hospitals are committed to sharing information about quality of health care services, but the dizzying array and volume of quality measures is a burden on providers and confusing to patients. A more manageable list of high-priority quality data would be more meaningful to all.


31 Leadership

The Ethical Leader

Health care organizations are moving toward value-based business models and assuming more risk, which can make ethical dilemmas more prevalent in the past. Here are practical steps board members and executives can follow to ensure ethical decision-making.


33 Value-based Care


As hospitals move out of the fee-for-service payment system, many are assuming more risk when it comes to reimbursements. These three steps can help trustees encourage their organizations to use population health management approaches that improve quality and efficiency.


35 Executive Compensation

Center Voices

Fundamental changes now underway in health care could take 10 years or more and will be financially challenging. As a result, more boards are extending the performance periods in their executives’ incentive compensation arrangements to align with longer-term indicators of success.