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A hospital-physician network spanning multiple partners may be an ideal fit for a smaller system

Recruiting board members is a challenge for every hospital and health system, but the task is particularly difficult in small communities. At Benefits Health System, Great Falls, Mont., our pool of candidates is largely limited to the city’s 60,000 residents, despite the fact that we are the tertiary referral center for a population of 250,000 across nearly 40,000 square miles of rural Montana.

When someone walks into your hospital, his first impression is created by the physical architecture. But his lasting impression — and what he is most likely to talk about when he returns home — will be determined by what we call the “invisible architecture” of core values, organizational culture and behavioral expectations.

Executives, trustees and physicians should be the leading advocates of philanthropy.

The emerging health care environment has changed the game for health care organizations and for physician leadership. The turbulence of that environment is going to require what could be called “agile organizations” adept at matching leadership and decision-making styles and setting and executing strategies appropriate to the nature and depth of environmental change.

The traditional acute-care hospital is becoming just one of the entities within a larger system that probably includes primary and specialty care clinics, ambulatory care sites, behavioral health care and post-acute care. In addition, the systems may be employing physicians, developing robust philanthropic organizations, developing entrepreneurial businesses, conducting research and offering medical education.

The complexity around physician compensation demands defined, layered board oversight

Establishing well-organized and consistent governance processes and procedures enables the board to be most productive, and ensures that its time is allocated to the most critical topics. Agendas should reflect the most important strategic issues and priorities, and make efficient use of trustees’ valuable and limited time; meetings should be designed to maximize trustees’ ability to engage in critical dialogue; and committees and task forces should be used to enable the board to focus time on high-level strategic discussion.

The U.S. health care system is quickly moving toward a care delivery model that encompasses entire populations, not just the patients who present themselves for care. This is because many at-risk individuals in the community seldom, if ever, seek treatment or health screenings—and they have a disproportionate impact on total health care spending.

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.

This Mind Map, developed in association with innovation partner HDR, depicts a variety of business objectives in healthcare today that are top of mind for healthcare strategists.

Mentoring, a process that pairs board members who are new to their roles with more seasoned board and executive resources for growth and development, traditionally has been used by health care boards to orient new trustees for board service.

As hospitals buy physician practices, board compensation oversight must shift into high gear.

Society and industries are always evolving; revolutionary change occurs sporadically when powerful forces align to disrupt the old order. The health care delivery system today is in the midst of an historic transformation to redesign how care is delivered. The quite immodest aim is to take 20 to 30 percent of costs out of the system while maintaining or improving clinical outcomes and patients’ health.

With CEO support and opportunities for education, trustees can become better hospital leaders

Steps CEOs and boards should take to understand and improve engagement.

Although scorecards that measure health system performance against established metrics have become an increasingly common and useful tool in the trustee’s governance toolbox, finding concrete, comprehensive ways to measure how well the organization is achieving its strategic goals — and, in turn, determining incentive compensation based on goal achievement — can be a daunting, ephemeral task. Here’s how one health care system has successfully connected all the dots.

Our understanding of effective governance in hospitals and health systems is growing. Several recent studies find that meeting certain benchmarks for board structure, composition, culture and evaluation practices has become a basic governance responsibility. These studies also call for heightened board engagement in governance oversight responsibilities.

Given the sweeping changes in health care, forward-thinking hospitals, systems and medical centers are carefully evaluating board member succession and recruitment. The challenging environment in which these organizations operate requires strong, knowledgeable boards whose members have deep insights into the field and a fundamental understanding of business, management practices and how to compete in a highly competitive market.