What is the difference between governance and management? Is there a fixed line that separates the roles and responsibilities of the board from those of an organization’s executives?

“Microgovernance: The Changing Roles of the Board and Management” is the topic of the Trustee Workbook to appear in the July issue of Trustee magazine. Authored by James E. Orlikoff and Mary K. Totten, this workbook explores the myth of an immutable line between governance and management and how the role of the board in relation to management is changing due to intensifying internal and external pressures on hospitals and their boards.

Orlikoff and Totten coin a new term, “microgovernance,” to describe work now required of boards to govern effectively and manage risk that, in the past, would have been considered micromanagement, but which the authors suggest is appropriate and necessary in the current environment. They discuss several emerging issues—such as new IRS reporting requirements, SOX migration, the need for heightened oversight of quality and patient safety, changing relationships with physicians, increasing competition with insurers—and the more detailed governance oversight activities they now demand.

Orlikoff and Totten challenge boards to explicitly and regularly discuss and determine with management relative roles and responsibilities. They also remind boards that they must sustain the essential balance between the demands of microgovernance and the strategic, big-picture role boards always have and must continue to play for their hospitals.

Questions for discussion, an exercise to help boards determine the right balance between microgovernance and strategic governance, and tips for effective microgovernance are included to help boards intentionally navigate this new governance terrain.

For more information, be sure to look for the complete workbook in the July issue of Trustee magazine. Center members can access the workbook electronically beginning June 1st via the Center's Web site.

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The Center for Healthcare Governance wants members to be as connected as possible to our governance consultants. Being able to ask questions online and receive responses back quickly will ensure you'll find the answers and resources to help you achieve excellence in health care governance.

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The Center for Healthcare Governance developed Speakers Express to help make the high-caliber speakers and presenters found at its national symposia and regional workshops available to organizations throughout the country. Our speakers are proven professionals who are viewed as the "go-to" leaders in their respective fields of expertise, customizing their presentations to fit the unique needs of each organization.

The Center for Healthcare Governance introduces Larry Walker, president of the Walker Company, which specializes in governance development, market research, leadership retreats and strategic planning for hospitals and other health care organizations. Learn more about Larry Walker below:

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