Resource Library

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.

Health systems and hospitals are becoming increasingly complex, expanding beyond the traditional hospital/parent company model to include new structures and strategic partnerships to support a wide range of care for patients in their communities.

Innovation can fuel the organizational agility necessary to achieve breakthrough levels of value and performance in health care. This Workbook describes a four-step process that health system boards and leaders can use to develop a sustainable innovation capability. Drawing techniques and perspectives from health care and other fields, the approach facilitates organization-specific solutions.

This publication discusses observations and trends about system development and identifies models of governance that are emerging as new organizations form and determine what it really means to become a system. It also reviews issues and obstacles that can arise as models of governance change and suggests steps boards can take to address them on the path toward more effective system governance.

Great Boards talked further with author Casey Nolan, managing director of Navigant’s Healthcare Provider Strategy Practice, Washington, D.C., about how boards typically function and the challenges they are likely to face at each stage of development. Nolan also discussed what board members need to know to govern effectively and add value as their systems evolve.

This monograph addresses the multiple accountabilities of nonprofit health system boards for the cost, quality, and safety of the services their facilities provide, the manner in which these accountabilities are being fulfilled, and issues we believe warrant attention by system leadership in order to retain and build public confidence, respect, and trust.

This research report examines the structures, practices, and cultures of community health system boards and compares them to several benchmarks of good governance. Its conclusions and recommendations get down to straightforward practical measures that a hospital or health system board can implement. Among others, they include blueprints for evaluation of the board’s strategic and bread-and-butter performance, plus review of membership composition. Well-noted are recommendations for essential board development and attention to community benefits.

Today, slightly more than 50 percent of the nation’s hospitals identify themselves as being part of a health care system. Systems come in all shapes and sizes. Some are large and comprise many hospitals across a wide region, including, among others, nursing homes, physician groups and insurance companies

A key governance design challenge in healthcare systems having multiple boards with parent-subsidiary relationships is specifying the most effective/efficient subdivision and coordination of responsibilities and roles among them. The questions that must be addressed are: