A blue ribbon panel examines good governance, providing recommendations and tools for board members and executives of health care organizations.
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| Donald C. Wegmiller | Kevin M. Fickenscher, M.D. | Douglas D. Hawthorne |
Providing better service; improving health care quality and patient safety; releasing information about the outcomes, costs and charges for care; securing public and stakeholder trust--these are just some of the demands on health care governing boards.
While all health care leaders should heed the call to address these important issues, it is the board members of each institution who must take initiative and lead by example. The board must hold itself to a higher standard of performance and accountability by engaging in practices that foster exceptional governance. There is increasing evidence that good governance at health care organizations is linked to better organizational performance.
From Good to Exceptional Governance
With funding from the executive search firm Russell Reynolds Associates and the American Hospital Association, the Health Research & Educational Trust and the Center for Healthcare Governance convened a blue ribbon panel of hospital and health system board members, CEOs, foundation executives, academics and governance experts. Donald C. Wegmiller chaired the panel, which worked from November 2005 through December 2006 to describe effective practices of exceptional boards. Panel members examined the purpose and functions of boards, as well as the critical issues facing them.
The panel organized into three work groups to focus on (1) strategic focus, (2) architecture and (3) accountabilities. Each panel member served on one of the groups, then reviewed and commented on an overall report. The report of the panel was also reviewed in draft form by additional trustees and CEOs in the field.
The report, Building an Exceptional Board: Effective Practices for Health Care Governance, published by the Center for Healthcare Governance, contains the panel’s findings as well as recommendations to help boards advance from good to exceptional governance. Because several themes, such as the board-CEO relationship, cut across many aspects of governance, readers will find them addressed in more than one section of this report. Whenever possible, tools are provided from high-performing organizations to guide readers in how to implement the panel’s recommendations. The panel sees this report as a foundation for further examination of exceptional governance and invites ongoing responses, refinements and submissions of practices and tools.
The panel’s report provides recommendations and tools in the following areas:
Being an accountable board that earns and maintains the public’s trust. Accountability includes understanding traditional and emerging stakeholders and constituents and promoting transparency about the organization’s performance.
Building and sustaining a proactive and interactive board culture. This requires the right mix and number of people; attracting, recruiting and appointing them; setting board and committee objectives; evaluating individual member and full board performance; and establishing effective board education and development programs.
Laying a foundation for effective decision-making and board meetings. An exceptional board must develop and distribute governance information, conduct effective meetings and establish effective communication between meetings.
Focusing the board on key governance priorities. Key to achieving this focus are fostering the right kind of dialogue and providing organizational support for governance.
Clarifying authority and responsibility. Effective boards must define roles and responsibilities among the full board and its components, designate clear authority for decision-making, and strengthen the relationship between the board and CEO.
The report also contains stretch practices for boards that have already adopted many of the recommended practices.
A Touchstone for Health Care Boards
The report is not meant to be a one-size-fits-all road map or an exhaustive compendium of best practices, but rather a set of carefully chosen recommendations and practices that have been tested by boards and proven to be effective. The recommendations and practices included in this report range from some that exemplify basic governance blocking and tackling to others that offer an opportunity to stretch toward more sophisticated levels of performance. It is the panel’s intent that the discussion this report stimulates will promote change and a commitment to an ongoing process of governance improvement.
Boards that review the panel’s work will inevitably find themselves at different stages when they compare their own performance against the practices contained in the report. They also will need to consider how certain practices should be tailored to meet the requirements of different types of hospitals or health systems--faith-based or secular, community or governmental, small or large, etc. That is not only to be expected but also speaks to the value of this report, which is to serve as a touchstone for all boards that seek to better understand and improve their performance as well as value to the organizations and communities they serve.
It is the panel’s belief that board members who understand their purpose and function and who have the resources they need to govern well on behalf of their organization’s stakeholders will be able to focus on the right issues at the right time in the right way. Boards that accomplish that objective are exceptional indeed.
Donald C. Wegmiller, M.H.A., FACHE, is senior consultant and advisor for Clark Consulting--Healthcare Group in Minneapolis. Kevin M. Fickenscher, M.D., FACPE, is the executive vice president of health care transformation for Perot Systems Corp. in Plano, Texas. Douglas D. Hawthorne, M.H.A., FACHE, is president and CEO of Texas Health Resources in Arlington.
The panel’s report is available from the Center for Healthcare Governance. To obtain a copy or ask for more information, please call (888) 540-6111.
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This article 1st appeared on February 6, 2007 in HHN Magazine online site.
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