2007 Blue Ribbon Panel Report

- August 25, 2010

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Building an Exceptional Board: Effective Practices for Health Care  Governance

Health care governance is at a crossroads.  As boards shift away from a focus on compliance and monitoring toward a value-added orientation, their work is migrating beyond an emphasis on operations and toward strategic and collaborative leadership.  At this juncture, several fundamental questions emerge that must be addressed to facilitate governance transformation.  These questions include:

1. Are boards, as they exist and operate today, truly necessary for future success in health care?  Why?
2. Has past health care governance added maximum value for health care organizations and their stakeholders?  If so, how, and if not, why not?
3. If boards are to play an important future role, what changes to their structure, function, processes, and culture are necessary?
4. What barriers exist that impede board effectiveness?

HRET, with funding from Russell Reynolds and Associates and the Center for Healthcare Governance, convened a Blue Ribbon Panel on Healthcare Governance to examine key health care governance practices to determine:

• The critical practices that boards must perform well to effectively and strategically lead their organizations now and into the future
• Aspects of current governance that need to be re-examined or modified to meet future challenges and to improve overall performance and accountability
• New insights about governance—in health care and other sectors—that have important implications specifically for health care boards
• Information and resources that boards will need in order to better understand how they can improve performance of these practices and transform their thinking to increase overall governance effectiveness and move toward becoming exceptional boards

Panel members included board members and chief executives of hospitals and health care systems, consultants, governance researchers, and others with expertise in leadership and governance.  The panel identified and focused their deliberations on five areas they believed were critical to effective governance:

• Being an Accountable Board:  Earning and Maintaining the Public’s Trust
• Building and Sustaining a Proactive and Interactive Board Culture
• Laying a Foundation for Effective Decision-Making: Board Meetings and Information for Governing
• Focusing the Board on Key Governance Priorities
• Clarifying Authority and Responsibility: The Buck Stops Where?

The Blue Ribbon Panel’s report, “Building an Exceptional Board: Effective Practices for Health Care Governance” includes the panels recommendations in each of these areas, as well as sample tools and resources to implement them.  It is intended to foster broader dialogue and sharing, among health care organizations and their boards, of perspectives and resources to further strengthen and improve health care governance.

Contact Deborah Bohr at dbohr@aha.org for further details.