Resource Library

A diagnostic tool and organization assessment can help boards address barriers to effective quality oversight.

These are exciting and challenging times for board members of not-for-profit health care organizations. The main driver of this state of affairs is a field-wide transformation that promises to result in better quality, higher value, and population health improvement. Most board members see this as a positive move for their organization and community, since their missions often speak to the need to improve the health of the communities they serve.

The following is intended to be an example that boards should adapt to meet their individual needs. Effective governance depends on the right mixture of skills, experience, personal qualities and diversity among the members of the hospital board.

“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.

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.

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?

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

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

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.

Great organizations have great leadership— at the top and throughout their ranks. 

These documents are based on CHP’s core values, the CHP board’s roles and responsibilities, and the expectations established for CHP’s board members. They may or may not fit other boards’ situations. Each board should adopt its own individual competencies and evaluation instrument. Reviewing others’ efforts is a helpful reference point, but no sample should be used without modification.

Patient satisfaction scores are important metrics; they draw attention to the subjective experience of patients who received care from a hospital.

Board self‐evaluation is an important process. Surveys by The Governance Institute have shown that making self‐assessment a board priority is associated with high performing boards. Yet, amidst seemingly more important board business, it’s easy for self‐assessment to become a rote exercise.