Hospital and health system boards need to ramp up their efforts to change with the times, or risk being outdated and leaving their organizations in a lurch.

A new survey report from the Center for Healthcare Governance indicates that boards could be doing more to speed the transformation taking place at hospitals and health systems. Importantly, the survey found a disconnect between how CEOs and board chairs assess board readiness for ushering in a new era of care delivery.

Not surprisingly, board chairs scored their boards higher than the CEOs did in three important areas: board engagement in examining emerging governance models for possible adoption; engagement in having a candid strategic discussion about what transformation means for the organization; and engagement in developing a new vision and strategy for transformational change.

In other words, CEOs don't think boards are moving fast enough to get ready for the transformation of health care.

"What we're seeing is that they are knowledgeable about the need to change, but they have not been having all the discussions that they might have about how to change," says John Combes, M.D., president and chief operating officer of the center, which is an affiliate of the American Hospital Association. "They know they need to change, and they can see the transformational change happening around them, but how engaged they've been in developing a new vision and strategy is a little bit surprising that it's not stronger than it is."

The consulting company McKinsey & Co. came to similar broad conclusions in a report last year that suggested better engagement and self-evaluation by boards led to better organizational performance.

The center's survey covers a lot of other ground and suggests that boards also need to be more knowledgeable about physician alignment and community health, especially as those concepts become more engrained in health care's second curve. In his blog Monday, Paul Keckley offered some suggestions on the how hospitals and boards can become more adept at embracing second curve strategies.

To boost that engagement and education, Combes suggests that board members take better advantage of such things as distance and remote learning.

If a board wants to remake itself but doesn't know where to start, it might take a look at eight strategies offered by governance consultant Jamie Orlikoff.

The report also contains insights regarding CEOs' expectations regarding their own accountability for health care quality, numbers showing a lack of progress in improving management and board diversity, and signs that board control is diminishing at the local level.

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