Resource Library

Latest findings point to several positive trends and opportunities for improving governance structures, practices and performance. The report includes expert commentary and discussion questions for board reflection.

This series of brief videos and accompanying board discussion questions features prominent health care governance experts offering advice on key issues that boards need to address in this rapidly changing health care environment.

What is the board’s role in shaping culture? Several health care leaders offer advice that reflects the diversity of their experiences.

An external review of workplace operations produces a Leadership Letter with observations and recommendations for continuous improvement, followed by open discussion among the board, CEO and top management.

To understand how the organization really functions on a day-to-day basis, boards need to gauge the hospital’s work life and its efficacy. Board responsibilities include: (a) understanding the hospital’s operating model and whether it actually performs in that mode, how critical decisions are made, and the hospital’s ability to recognize its own problems and “self-correct”; and (b) ensuring that it happens.

The seismic forces currently roiling health care present boards with a new set of profoundly consequential strategic options. These often involve significant risk, major mission shifts, and challengingly short windows of opportunity.

Health care is ripe for change. The evidence is all around us. A majority of health care leaders recently surveyed said hospitals and health systems are most in need of disruptive innovation (New England Journal of Medicine Catalyst, February 16, 2017). Consumers are taking charge of their own health and seeking providers that deliver high-quality, affordable and accessible care in ways they have come to expect from their favorite retailers. And disrupters from within and outside of health care are joining forces and competing with traditional health care organizations to give consumers what they are looking for.

Standard Work for Governance Example Source: St. Charles Health System. Used with Permission. Lean principles and practices drive performance improvement by clarifying the steps involved in work processes to avoid wasting time reinventing how work should be done. The board of St. Charles Health System in Bend, Ore., developed “standard work” for several board processes to improve governance performance. An example of standard work for biannual distribution of director stipends appears here.

Value creation occurs at many levels in organizations. This chart, used by St. Charles Health System based in Bend, Ore., describes the unique role of governance as well the roles of leadership, management and front-line workers in applying Lean principles to support sustained organizational improvement.

This webinar makes the case that the time has come to develop a new model of hospital and health system governance. Presenter Jamie Orlikoff discusses four phases in the evolution of the current model of governance and ongoing market and organizational pressures that make it difficult for the current model to withstand, and he suggests that these pressures are likely to deepen as their pace, scope and scale accelerate.

The crisis brewing in the traditional governance model requires conscious construction of new models relevant to new times.

This webinar provides specific examples of and practical tools used by the highest-performing boards as they move toward five categories of advanced governance practices: Visionary, Strategic and ‘System’-focused; Nimble, Streamlined and Clear; Intentional, Disciplined and Consistent; Competency-based, Educated and Evaluated; and Objective, Transparent and Accountable.

“No battle plan survives the first contact with the enemy,” goes a military saying, expressed in recent years by Colin Powell. The expression is worth remembering as hospitals and health systems embrace bold strategies to participate in the industry-wide economic shift from rewarding volume to holding providers accountable for the value they deliver.

Just as the health industry continues to shift care delivery from a volume- to a value-based model, so too must the health care board evolve beyond its traditional fiduciary and core governance responsibilities to encompass a more strategic and global view. The success of this evolving model depends on shared governance—a stronger alignment and engagement among the board, physician leadership and management.

Today’s hospital leaders know their trustees must be more adaptable, connected and knowledgeable about the changing health care landscape than any of their predecessors. But do they believe their volunteer community board is truly capable of stepping up to current field challenges?

The highest-performing boards across the country share certain key characteristics that can be grouped into five categories - visionary, nimble, intentional, competency-based and objective.

The AHA’s 2017 report documents how leading health care organizations and their boards, in collaboration with other community partners, are beginning to expand efforts to addressthe myriad of social determinants that significantly affect the health of their communities.

The Triple Aim of improving the experience of care, improving the health of populationsand reducing per capita costs of health care is a nationally recognized goal that provides context for much of the work now underway to redesign existing systems for care, payment and collaboration to achieve better health outcomes for all Americans.

Traditional community-based boards in health systems and hospitals have long been the stalwart of health care governance because of their value in connecting health care organizations to the communities they serve.

Guided by their organization’s mission, vision and values, trustees must govern with their eye on the future, the well-being of patients, and the health of their communities.