Supporting High-Performing Boards: Is It Time for Dedicated Governance Leadership?

Originally published in Trustee Magazine, April 2017

By Luanne R. Stout, Joann McNutt and Mary K. Totten

Some 66 percent of U.S. hospitals are now part of health systems, according to 2016 survey data from the American Hospital Association. As systems continue to grow in scope and complexity, their governance often follows suit. System growth typically results in more boards, at least in its early stages, and reallocation of governance roles and responsibilities among boards at different levels and functional areas in the system.

For example, roles and responsibilities for the board of a clinical enterprise are likely to look different from those of a system board or a subsidiary hospital board. A centralized or highly streamlined governance structure may work well for some systems, while others function better with more boards — although their roles, responsibilities and authority need to be clearly defined and thoughtfully integrated. As system maturity creates the need for governance to evolve, more sophisticated, nuanced governance creates the need for more and better board support. We believe an opportunity now exists to examine how boards can best be supported to help their maturing systems reach their full potential.

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