Principles and Best Practices for Effective Governance

By Barry S. Bader

The trustees of one health system were divided over how to structure the board. Some favored proportional representation from its acute care, nursing home and elder services divisions; others wanted all at-large members with no interests to promote.

The CEO of another health system had restructured so facility executives were directly accountable to corporate management for finances and operations. He wanted local boards to focus on strategic direction and oversight of quality, but local boards continued monthly monitoring of finances as they’d always done. Some trustees wondered what their role was.

At a third health system, a new trustee was surprised to learn the organization had no strategic plan … at least not one that identified major initiatives and set measurable performance goals, the kind he’d developed as a successful corporate executive.

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