Competency-Based Governance Enters the Health Care Boardroom


In 2009 the AHA’s Blue Ribbon Panel on Trustee Core Competencies identified two sets of competencies that focused on the knowledge, skills and personal capabilities needed by trustees of hospitals and health systems to govern effectively. Realizing that the application of competencies to board work in health care was at an early stage, the panel recommended that tools and resources be developed that would help health care organization boards apply the competencies to a variety of governance practices.

A Blue Ribbon Panel Work Group of health care governance experts and health care organization trustees and chief executives was convened later in 2009 to carry forward the panel’s recommendations.The Work Group, with funding from Hospira, a global pharmaceutical and medication delivery company and a member of the Center for Healthcare Governance, explored how boards could use competencies in four governance practices: board member selection, education, performance evaluation and leadership development and succession planning.The Work Group developed sets of tools and resources that incorporated trustee competencies into each of the four governance practices listed above.The tool sets were then tested by a group of hospitals and health systems and made available to the field in 2010.

This monograph describes competency-based governance and explains the processes and resources developed by the Blue Ribbon Panel Work Group to help boards integrate competencies into their work. It is intended as an introduction to the Competency-Based Governance Tool Kit, a comprehensive resource that includes all of the tools developed by the Work Group and provides guidance for implementing them.

Together, this monograph and the Tool Kit will be particularly useful to board Governance Committees and board leaders interested not only in improving individual trustee performance, but also the performance of the board as well. A growing body of research is strengthening the link between trustee, board and organizational performance. In this era of reform, health care governing boards can take an important first step to deepen that link by developing the competencies their members need to capably perform the important and critical governance work that lies ahead.

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