Resource Library

The role of a health care organization trustee is getting more complicated and more sophisticated every day. Pressures are increasing simultaneously for higher quality, lower cost, more transparency and accountability, and use of evolving and ever-more-expensive technology.

There’s hardly a health care board member, past or present, who hasn’t heard of the age-old governance mantra “no margin, no mission.” For years this simple phrase captured what most trustees came to believe was their primary obligation: to ensure the financial viability of their hospital or health system. Days cash on hand, debt coverage ratio and net operating margin were key measures that defined high or low performance.

The hospital's board chair picks up the phone in his office at TriState Bank headquarters. The CEO’s voice on the other end of the line is stark and serious. “The medical executive committee just gave me a unanimous no confidence vote,” he says. “They’re complaining about closed communications and aloofness. And the Gazette called and wants to talk about my compensation."

The role of a health care organization trustee gets more complicated and more sophisticated every day. Pressures are increasing simultaneously for higher quality, lower cost, more transparency and accountability, and use of evolving and evermore expensive technology.

Hospital and health system boards are being overwhelmed by hundreds of quality indicators from numerous sources. Many are required or linked to payment incentives, but some are part of voluntary improvement programs. Amidst the deluge of numbers, leaders could miss valuable, potentially actionable information.

Over the past decade, we have learned much about board effectiveness. A growing body of research has systematically confirmed the intuitive link between board and organizational performance: higher-performing boards are associated with higher-performing organizations.

The 2007 report of the Blue Ribbon Panel on Health Care Governance focused on building a foundation for exceptional governance and included several tools and practices to help boards move from good to great performance.

This monograph covers the basics of strategic planning, including definitions of common terms, a description of the planning process and the characteristics of successful plans. It describes the board’s role in planning, including why plans fail, common weaknesses and how boards can support successful plan implementation.

For effective oversight, boards must engage at three levels: see, own and solve.

A board committed to continuous improvement realizes that the value of assessing its performance goes beyond meeting Joint Commission or other external requirements. It knows that regular self-evaluation gives it the information needed to understand and build on its strengths and identify and minimize its weaknesses.

Mapping the values and concerns of stakeholders against company strategy is one way to show where stakeholder concerns are aligned with current strategy and to create awareness of where risk or reward exist.

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

This monograph discusses today’s market environment, current capital market perspective and related risks, and then outlines a project management approach and questions that must be addressed to help board members and executives more effectively manage capital project risks while achieving organizational strategies and goals.

This resource is intended to be an example that boards should adapt to meet their individual needs.

This research report examines the structures, practices, and cultures of community health system boards and compares them to several benchmarks of good governance. Its conclusions and recommendations get down to straightforward practical measures that a hospital or health system board can implement. Among others, they include blueprints for evaluation of the board’s strategic and bread-and-butter performance, plus review of membership composition. Well-noted are recommendations for essential board development and attention to community benefits.

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

In 2003, Princeton HealthCare System initiated a highly participative and comprehensive long-range strategic planning process. Among the participants were trustees, donors, physicians, elected officials, influential community members, and patients and their families, as well as administrators and clinical and service staff members. 

Elaine Zablocki found that recruiting more minorities and women to the board takes new ways of thinking about, recruiting and orienting directors.