Competency-Based Governance: A Foundation for Board and Organizational Effectiveness

The 2007 report of the Blue Ribbon Panel on Health Care Governance focused on building a foundation for exceptional governance and included several tools and practices to help boards move from good to great performance.

The Blue Ribbon Panel on Trustee Core Competencies was convened in 2008 to build on the earlier panel’s work:

  • to identify individual board member core competencies common to different types of boards that can be used to improve board and organizational performance; and
  • to provide guidance and direction for the field in developing educational and other resources that can be used to apply these competencies to the work of hospital and health system governing boards.

Panel members drew on their own experiences and reviewed work done by others to develop board and leadership competencies for both for-profit and not-for-profit organizations. The panel then identified two sets of trustee core competencies for board members of hospitals and health systems.

Knowledge and Skills

  • Health Care Delivery and Performance
  • Business and Finance
  • Human Resources

The panel recommended that all boards, regardless of the type of hospital or system they govern, should include some members with these knowledge and skills competencies.

The panel further recommended that the competencies included in the list below should be sought in all board members.

Personal Capabilities

  • Accountability
  • Achievement Orientation
  • Change Leadership
  • Collaboration
  • Community Orientation
  • Information Seeking
  • Innovative Thinking
  • Complexity Management
  • Organizational Awareness
  • Professionalism
  • Relationship Building
  • Strategic Orientation
  • Talent Development
  • Team Leadership

In addition to developing individual board member competencies, the panel also considered what makes a board an effective team and identified tools and resources to help boards begin to apply competencies to health care organization governance.

Lastly, this report also includes recommendations for boards, educators and researchers to carry the panel’s work forward to help the field better understand and practice competency-based governance.

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