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Governing boards traditionally call executive sessions from time to time to discuss confidential, proprietary or personnel related matters in closed session. In recent years, however, the increasing emphasis on board independence and vigilance has triggered a new use for executive sessions.

Health care governance has entered a new era of heightened accountability, scrutiny and reform. This era imposes significant new burdens and challenges on boards and has raised the bar on what is required and expected of them. As a result, many boards are shifting their focus away from strategic leadership toward becoming compliant custodians.

Board self-assessment is widely recognized as a fundamental building block of continuous governance improvement. For the past 20 years, many healthcare organization governing boards have engaged in full board performance evaluations, often on an annual basis. These evaluations are designed to assess the board’s knowledge of its roles and responsibilities and how well the board as a whole is discharging them.