Resource Library

The following is intended to be an example that boards should adapt to meet their individual needs.

This monograph discusses today’s market environment, current capital market perspective and related risks, and then outlines a project management approach and questions that must be addressed to help board members and executives more effectively manage capital project risks while achieving organizational strategies and goals.

The 2007 report of the Blue Ribbon Panel on Health Care Governance focused on building a foundation for exceptional governance and included several tools and practices to help boards move from good to great performance.

In 2003, Princeton HealthCare System initiated a highly participative and comprehensive long-range strategic planning process. Among the participants were trustees, donors, physicians, elected officials, influential community members, and patients and their families, as well as administrators and clinical and service staff members. 

A board committed to continuous improvement realizes that the value of assessing its performance goes beyond meeting Joint Commission or other external requirements. It knows that regular self-evaluation gives it the information needed to understand and build on its strengths and identify and minimize its weaknesses.

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.

The following is intended to be an example that boards should adapt to meet their individual needs.

Working committees are the engine that powers effective boards. As their responsibilities increase, boards depend on their committees to engage in careful analysis and oversight of the organizationʼs performance plus a thorough vetting of recommendations before they are submitted to the full board. When committees do their job well and make concise reports to the board, they free up time to use full board meetings for education and open discussion on important strategic and policy issues.

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.

Elaine Zablocki found that recruiting more minorities and women to the board takes new ways of thinking about, recruiting and orienting directors.

“What is the difference between governance and management?” is by far the question that not-for-profit executives and directors ask most often. Effective boards understand the difference between governing and managing; dysfunctional boards do not.

Hospital boards are beginning to take best practice cues from their corporate counterparts and modernize their communication methods by adopting board portals. A board portal is a secure “host”— i.e., an online storage system for managing trustee communications.

Almost all hospitals face the issue of not having enough money to accomplish everything they would like to. So how does the board pick among winning ideas when it can’t afford them all? The resources needed to support operations and implement strategic initiatives can far surpass those available.

This is the second in a series of collaborative leadership tools for CEOs. The first one presented a new model of collaborative leadership.This one focuses on clarifying trustees’ and CEOs’ expectations of each other. It includes a simple exercise for helping trustees and CEOs refine the way they work together.

Governing boards traditionally call executive sessions from time to time to discuss confidential, proprietary or personnel related matters in closed session. In recent years, however, the increasing emphasis on board independence and vigilance has triggered a new use for executive sessions.

Health care governance has entered a new era of heightened accountability, scrutiny and reform. This era imposes significant new burdens and challenges on boards and has raised the bar on what is required and expected of them. As a result, many boards are shifting their focus away from strategic leadership toward becoming compliant custodians.

Asset stewardship has long been a key board responsibility. As fiduciaries of a health care organization’s assets, governing boards are required to act in the best interest of the organization, ensuring that resources are used in a reasonable, appropriate and legally accountable way to meet community health care needs.

As governing boards seek greater diversity in ethnicity, race, and gender, they face a significant challenge: how to successfully recruit women and minorities with pertinent professional backgrounds and governance skills, while other not-for-profits and corporations seek directors from the very same pool of candidates.

Many governing boards are frustrated because most board meetings and committee meeting agendas are so full of both important and routine business that little time is left over for interactive discussion and questions concerning highly significant or future-oriented strategy and policy issues.

Hospitals and health systems generally employ more physicians than executives. At the same time itʼs likely that the board of directors spends far more time on compensation issues in the C-suite than on physician compensation and its associated regulatory and business risks.