Bringing Competencies to Governance: Systems Helping Systems



By Mary K. Totten

As health care organizations become more complex and diverse, their governance requires individuals with a range of knowledge, skills and behaviors that can address the needs and challenges of these evolving enterprises. As their organizations mature, effective boards update how their members are selected, often moving away from informal, relationship based board composition to a more intentional, competency-based process.

That process began six years ago for the board of Health First in Rockledge, FL. As the organization brought together its multiple entities into an integrated delivery network, it realized it was time for governance to evolve as well.

“We had committed people who had served on hospital boards governing our system,” says then board chair Jim Shaw. “But we realized our board did not have all of the skills we would need for the future.” Working with Steven Johnson, the system’s new CEO, the board moved from membership based on criteria such as geographic representation to a board composed of individuals with specific skills and experience with complex organizations.

“As we created our network we had some challenges that were sometimes difficult to work through for me and my team,” Johnson recalls. “Jim, who came from the aerospace industry, pointed out that we were viewing our organization as a health care company, and that in his industry we would be viewed as a systems integration company whose product is health care. This observation had a profound effect on me and ultimately influenced who we hired and who we brought onto our board.”

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