Resource Library

Board DevelopmentWonder, Wander and Round IntentionallyFour leaders speak to how rounding provides valuable insightBy Todd Linden"Not all those who wander are lost.” — The Lord of the Rings: The Fellowship of the Ring.

transforming GovernanceBoard Compensation: The Emerging New NormalWhat to make of the increase in boards that compensate their membersBy Jamie OrlikoffShould board members of not-for-profit, charitable hospitals and health systems be compensated?

Making coaching available to an incoming board chair can build the chair's capacity to lead the board effectively.

Despite the importance of the role, many boards do not give selection and preparation of the board chair the attention they should. In a recent survey by The Governance Institute, 64% of boards said they had established an explicit process for selection of the board chair but these processes often are little more than a thoughtful conversation among the executive or governance committee about the next chair.

For a hospital board to be effective, it must first be engaged. Specifically, board members must actively and productively participate in the work of governing. This is absolutely vital in today’s health care environment, which is full of volatility, uncertainty, complexity and ambiguity.

Whether a board’s starting point is average performance or mediocrity, the journey to the top echelon of governance effectiveness cannot be achieved with a few quick steps. Board development is more like a marathon than a sprint.

The tools that follow lay out a framework to assist you in that thinking and planning process with a focus on the competencies of individual trustees.

It would be hard to disagree with the notion that board development is essential to effective trusteeship. Anyone who has sat on the board of a hospital or health system knows that health care is recognized as one of the most complex sectors.

Are You Prepared to Meet Today’s Governance Challenges? Serving on a community hospital or health care system board in today’s challenging environment takes more than the desire to fulfill a fiduciary duty.

In some boardrooms, the topic of education for trustees elicits yawns, groans or even downright resistance. This may explain why findings from the AHA’s Center for Healthcare Governance 2014 National Health Care Governance Survey indicate a decline in every type of board education since the last survey...

Much has been written about the resources that hospitals should provide their board members to develop their governance expertise. Generally, a good orientation to the board’s work, educational sessions at board meetings, an annual retreat, periodic attendance at outside educational programs and frequent performance evaluation are some of the basics for any board.

Great health care boards primarily focus on enabling their organizations to create innovative solutions that address community needs for improved health and well-being. They also address regulatory, competitive, resource and other challenges that sometimes may seem daunting, but these do not divert them from their primary purpose.

The AHA’s 2011 Governance Survey shows that good governance practices continue to take hold among hospitals and health systems. Driven by powerful economic pressures and stringent legal requirements to be visionary, strategic, diligent and independent, boards are applying various “good governance” practices, including competency-based succession planning, board orientation and education, routine executive sessions, CEO retention planning, and board self-evaluation.

The rules of engagement for board members have changed dramatically. Historically, the trustee position was honorary; today, trustees are expected to interact more with management and the community and know more about operations.They also have added accountability for legal and regulatory matters. As this role grows in complexity, hospitals are challenged to prepare and educate board members efficiently to be effective fiduciaries without overwhelming them.

Over the past decade, we have learned much about board effectiveness. A growing body of research has systematically confirmed the intuitive link between board and organizational performance: higher-performing boards are associated with higher-performing organizations.

Effective board leadership transitions can be facilitated by institutionalizing basic tools and processes. These include setting term limits for those in board leadership positions, periodic evaluations based on clear job descriptions and assessment of potential barriers to successful CEO relationships.