Resource Library

“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.

New research on board structures, practices and culture in large nonprofit systems provides insight into how boards and CEOs are addressing the challenges of change — and changing the way they govern in the process. This workbook explores several themes emerging from review of system documents and 71 on-site interviews with CEOs and senior board leaders in 14 of the country’s 15 largest nonprofit health care organizations.

The AHA’s report on Hospitals and Care Systems of the Future is not intended to be one of those think tank documents that’s quickly forgotten when the next hot idea comes along. The report, which the AHA will update periodically to reflect changing conditions, is designed to help leaders engage in active, thoughtful exchanges about their desired delivery system of the future.

This chair position charter is grounded on a model of healthcare organization governance forwarded in Board Work by Dennis Pointer and James E. Orlikoff (Jossey-Bass,1999).

For boards to participate in shaping their new organization, they must be currently performing at an extremely high level. The following is a list of four practices that hospital and health system boards must be engaged in today, in order to be successful in the future.

A successful governance education process requires commitment, collaboration and consensus. This resource serves as an outline of how a board of trustees may design a process that will ensure optimum development of leadership knowledge and effectiveness.

To maintain the momentum of continuous governance improvement, many "best practices" boards institute regular mini-evaluations of board meetings. Here, each board meeting concludes with every board member anonymously completing a brief evaluation form of how the board planned for and used its time during the meeting.

Effective decision making often requires different techniques or approaches for different types of decisions. The following techniques and practices can help support and strengthen your board’s decision-making processes.

The road to integration of hospitals and physicians has been a rocky one for many health care organizations. Failed attempts to integrate in the 1990s resulted from the realization that operating physician practices was very different from operating hospitals, leaving many health care providers wary of heading down the same road again.

The organization’s most important stakeholders have been identified/specified. A descriptive/analytic profile has been prepared for each key stakeholder. The interests (needs/wants, expectations and organizational success criteria) of each stakeholder have been documented.

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.

The Hospital System Board of Trustees Quality Committee shall meet quarterly in order to provide: Visibility and focus for the organization’s commitment to the delivery of high quality medical care; Oversight of quality and performance improvement initiatives across the Hospital System.

Most boards and governance experts say boards should be meaningfully involved in shaping and ultimately approving the strategic plan and major decisions—but if they try to develop plans, they’re bordering on management. The tricky part is distinguishing meaningful involvement from development.

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?

High-performing boards across the country have made great strides in enhancing their effectiveness and efficiency.

Here are 10 steps for optimizing the way a board uses its meeting time.

Mergers and acquisitions (M&A) are occurring throughout health care, with transactions happening among entities of all provider types and sizes.(According to the latest analysis by Kaufman, Hall & Associates, LLC, 49 transactions were announced in the first half of 2015, up from 43 transactions in the first half of 2014.)

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.

Securing board approval for a major new project can be a long and tricky process when the CEO proposing it isn’t sure which criteria trustees will use, and the board is equally uncertain what the yardsticks ought to be. At Adirondack Medical Center in Saranac Lake, N.Y., President and CEO Chandler Ralph asked her board to write down and agree on project evaluation criteria. In a two-hour workshop, trustees came up with 14 points that they now apply to every decision about whether to implement a new program.

In industries where safety is critical and quality must come first, such as airlines and nuclear power, “red rules” refer to protocols that must be followed “to the letter” – all work stops until they are. A commercial airliner doesnʼt leave the gate if the pilot spies a possible leak or flat tire; a nuclear plant operator or even a Toyota assembly line worker can “stop the line” when he spots a critical flaw.