Trustee Toolkit

BOARD COMPOSITION AND SELECTION Sample Governance

Adapted from “Recruiting for a Diverse Health Care Board,” by Karma H. Bass (Trustee Insights, Dec. 2020).

Tools for the Root Cause Analysis (RCA) team, including a review a sentinel event, to understand why the event happened, and to decrease or eliminate a like event from occurring again.

There are better ways to honor and, as appropriate, continue to involve former trustees, while also adhering to the higher standards demanded of boards today.

As this grid suggests, good governance decision-making, when supported by a variety of board practices and tools, strengthens the board as a whole and its capacity to govern well.

Checklists A Trustee Checklist to Address Time Challenges As

The sample dashboards that follow provide examples for a multihospital system as well as a single community hospital.

An effective board chair/CEO relationship is essential to support governance excellence and begins with a clear understanding of individual and shared accountabilities. Dallas-based Methodist Health System defines these accountabilities in a board chair/CEO compact (shown below) that is used as both an orientation resource for new board chairs and a touchstone for ongoing evaluation of this critical relationship.

Doing your duty is not just about success; it is also about actively engaging in practices that promote good governance. Take this quiz to review and reflect on how your board compares with governance best practices.

To understand how the organization really functions on a day-to-day basis, boards need to gauge the hospital’s work life and its efficacy. Board responsibilities include: (a) understanding the hospital’s operating model and whether it actually performs in that mode, how critical decisions are made, and the hospital’s ability to recognize its own problems and “self-correct”; and (b) ensuring that it happens.

By tracking outcomes, the committee can ensure that the program operates consistently with the established philosophy and that areas requiring attention are readily identified. When combined with comprehensive tally sheets and affirmation that all executive compensation arrangements are fully disclosed to the committee, there is a comprehensive baseline underlying the committee’s deliberations.

As health care organizations face a number of emerging challenges, the compensation committee of the not-for- profit hospital and health system board is well served to review and update the executive compensation program periodically.

A good coach focuses on what the board chair wants to accomplish and designs a coaching process based on how the board chair experiences the role; on assessment of individual strengths and weaknesses; and on identifying and addressing blind spots. Each coaching process should be customized to meet the board chair’s individual needs and goals.

The template is designed to help a hospital or health system develop profiles of disruptive competitors that are already in its service area (or are anticipated to enter its service area). An interactive MS Word document of this template with fields is available.

Standard Work for Governance Example Source: St. Charles Health System. Used with Permission.

By Stephen Mansfield While a clear, bright line between the roles of governance and management does not exist for every issue that boards and orga

While your organization may strive to improve safety, patient experience, workforce engagement and clinical quality as discrete performance domains, your leadership — and your resources — may be convened around multiple strategies and action plans. Without a single strategy that aligns improvement efforts and acts on the interdependencies of vertical domains, siloed planning can undermine workforce coordination and sustainable change.

Value creation occurs at many levels in organizations. This chart, used by St. Charles Health System based in Bend, Ore., describes the unique role of governance as well the roles of leadership, management and front-line workers in applying Lean principles to support sustained organizational improvement.

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

This chair position charter is grounded on a model of healthcare organization governance forwarded in Board Work by Dennis Pointer and James E. Orlikoff (Jossey-Bass,1999).