Building A Bolder Board–– and Learning To Like It
By Terese Hudson Thrall
Source: January 2007 issue of HHN Magazine

In today’s complex and closely scrutizined health care environment, trustees must bring expertise and independence to their roles. That’s good for hospitals and for CEOs.

The extreme pressure that not-for-profit hospitals are under requires a new playbook for their boards—they need to be involved in strategic issues and they need to lend their expertise in ways that will improve operations.

“Boards are more engaged,” says governance consultant Barry Bader. “The unforgiving payment and competitive environment have increased the risk of business decisions, and external scrutiny has underscored the importance of board oversight.”

James E. Orlikoff, a governance consultant and hospital trustee, says the mandate is clear. “Not a week goes by that there’s not a front- page story about a board doing something wrong or being challenged,” he says. “People who would have stared at you blankly if you wanted to talk about good governance five years ago can now talk to you about fiduciary duty and board oversight of CEO compensation.”

While hospital board chairs around the country say their trustees—who often also serve on or report to corporate boards—are aware of the heightened scrutiny by Congress and by state attorneys general, the primary motivation for changing how they operate is simply to improve the organization.

That was the case at Presbyterian Healthcare Services, an eight-hospital system in Albuquerque, N.M., ham- pered by a cumbersome, 24-member board. In 2001, the board was cut to 11, keeping only seven of the original members. Trustees also got new marching orders: Take personal ownership of board issues. “We wanted to embrace the Baldrige National Quality Program criteria and we couldn’t do that with old-style governance,” explains board chair Larry Stroup. The old board often heard management reports, but didn’t get into discussing the real business of the hospital system. “No one had individual ownership of the issues,” he says. “Now every member has ownership of certain aspects of what is going on; it’s their board and their system. The board really debates the issues and holds management accountable for results.”

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Critical Issues in Health Care System Governance
June 19-20, 2007
Loews Philadelphia Hotel - Philadelphia, Pennsylvania

Overview | Agenda

Who Should Attend:

• Health care delivery system and member hospital CEOs and senior executives
• Trustees who serve on system boards or on the boards of the system's member hospitals

Learning Objectives

• Understand how health care system governance differs from governance in independent hospitals
• Address the specific roles and responsibilities of system boards to chart strategy, promote clinical improvements, and engage physicians across the organization
• Gain insights into the practices and processes that can improve the performance of system boards
• Explore how diverse organizational cultures, planning processes, and decision-making approaches can thrive in a multi-hospital system

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