Trustee Toolkit

The American Hospital Association’s report, Hospitals and Care System of the Future, describes the transformation of health care delivery from first curve to second curve, driven by a shift from volume driven to value-driven payment systems. While there is no single “end state” model that suitable for all organizations or communities, the report offers a compelling vision of “care systems” that are accountable, integrated and coordinated around patient and community needs.”

See the attached sample strategic planning policy.

This checklist poses questions about whether your board is following recommended practices for strategic planning.

Board policies do various things. Some describe how important processes, such as board self evaluation and CEO evaluation, are carried out. Other policies address standards of conduct such as a conflict of interest policy. Still others clarify delegations of authority such as the levels of authority granted to subsidiary boards, board committees and the CEO.

The board has three legal duties: a duty of obedience to the charitable purpose of the organization, a duty of loyalty, to act based on best interests of the organization, and a duty of care. The role of the board is to govern, not manage, the organization.

To expedite the conduct of routine business during board meetings in order to allocate more meeting time to education and discussion of substantive issues.

The dashboard or “balanced scorecard” has become a staple of effective governance. Charts and numerical data provide a comprehensive picture of organizational performance. Here are some questions to assess whether your board’s dashboard is as good as it could be.

Responsibilities and expectations for board chairs are identified and defined.

To clarify the difference between the board’s policy making responsibilities and management’s operational responsibilities.

Overall Roles and Responsibilities -The Governance Committee provides for the board’s effectiveness and continuing development.

A Board Orientation Manual reinforces information provided during orientation seminars. Consider these items in custom-designing an orientation manual for your board.

CEO goal-setting and evaluation is a fundamental responsibility of a governing board. These questions are designed to help boards assess their CEO evaluation process and determine if any improvements are necessary.

The Quality Committee assists the board in overseeing and ensuring the quality of clinical care, patient safety, and customer service provided throughout the organization.

All new board members should participate in an orientation process shortly after election to the board. To design your board’s orientation process, consider these best practices.

Regular board self-evaluation is integral to effective governance. Use the questions in the attachment to assess whether your board is getting maximum mileage from its self-evaluation process.

An increasing number of boards are moving away from having a standing committee on strategic planning. They reason that the entire board should understand and have a role in major decisions about the organization’s strategic direction, programs and services.

Be sure every member fully understands his or her accountability, responsibilities and the expectations of the office, and document it all in a written position description...

The following is intended to be an example that boards should adapt to meet their individual needs. This self-assessment tool will provide you an opportunity to evaluate our committee’s performance and contributions.

The American Hospital Association’s report, Hospitals and Care System of the Future, describes a series of “must do” strategies and future core competencies hospitals will need as they transform themselves from first curve to second curve delivery systems, driven by a shift from volume-driven to value-driven payment systems.

For boards to participate in shaping their new organization, they must be currently performing at an extremely high level. The following is a list of four practices that hospital and health system boards must be engaged in today, in order to be successful in the future.