Shared Governance Imperative

By Pam Knecht

Just as the health industry continues to shift care delivery from a volume- to a value-based model, so too must the health care board evolve beyond its traditional fiduciary and core governance responsibilities to encompass a more strategic and global view. The success of this evolving model depends on shared governance—a stronger alignment and engagement among the board, physician leadership and management.

Health system leaders and their boards must determine how to best move from fragmented to coordinated care, going beyond treating individual patients to providing care for patient populations, and shifting from payer-driven managed care to provider-driven accountable care. In other words, they must chart a course for becoming clinically and fiscally accountable for the entire continuum of care that their patient population may need.

None of these new goals replaces the board’s fundamental responsibilities, however, which include: ensuring competent management, as well as clinical quality, service and safety; advocating for those served and the organization; perpetuating effective governance; protecting the financial health of the organization; and setting strategic direction—all of which must tie back to the hospital’s core mission, which the board is further charged with developing, overseeing and maintaining.

In addition to understanding and carrying out their basic oversight duties, boards need to maintain clarity around the distinction between their roles and those of the C-suite. While it is the responsibility of governance to set organizational goals, make major policy and strategy decisions and oversee their implementation, management’s job is to deliver results by implementing those policies and strategies, as well as managing operations and reporting on performance.

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