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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 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.

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.

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.

This article outlines agenda items for the board’s Executive Compensation Committee. It is the first of several that will further explore many of the agenda items discussed below.

A 2012 study of Governance Practices in an Era of Health Care Transformation conducted by AHA’s Center for Healthcare Governance found that work to create greater value is where hospitals and systems in the study— and their governing boards—are spending most of their time. According to study findings, participating organizations “are concentrating on the nuts and bolts of… reducing costs and improving care quality.” The work is wide-ranging and intensive:

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.

Don’t overlook the importance of CEO-board etiquette — it’s a pillar of good governance. The relationship between boards and chief executive officers can be fraught with challenges, and trustees often are unsure of how to handle certain delicate situations. But using a framework of etiquette can provide guidance.

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

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

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.

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

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.

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.

An emergency succession plan may never be used, but it’s still a necessity for every hospital. A key function of every board is to ensure that effective leadership is in place so that the institution it governs can continue to achieve its mission, vision and strategic goals.

The relationship between boards and chief executive officers can be fraught with challenges, and trustees often are unsure of how to handle certain delicate situations. But using a framework of etiquette can provide guidance.

Four basic rules can help boards make better executive compensation decisions. While boards and their compensation committees do a good job of overseeing executive compensation, there are several common flaws in what is otherwise a strong process.

Board support is essential in helping doctors take on and succeed in leadership roles. The emerging health care environment requires far more physician leadership than has been needed in the past. But there is a natural barrier to physicians who answer the call to lead, and it is best described as “physician whiplash.”

Now that the Affordable Care Act has been upheld, it appears that the American health care delivery system is about to embark on unprecedented change. This transition encompasses a staggering number of issues: integration and physician alignment; significant reduction in Medicare reimbursement; heightened emphasis on quality and safety; the need to evaluate and pursue partnership options, such as mergers and affiliations with health care providers along the continuum of care; defining and delivering accountable care; and ultimately the complete transformation of an acute care based system to systems of care that promote and encourage population health.