Being a Better Board Member
Board participation and management is a growing concern in health care. The IHI has recently published a how-to guide on governance leadership (www.ihi.org/IHI/Programs/Campaign).
This study states that:
Outmoded views of hospital governance sometimes suggest that hospital boards are responsible only – or primarily – for the organization’s financial health and reputation… But the board’s duties do not end with financial stewardship. Boards oversee mission, strategy, executive leadership, quality, and safety on behalf of the owner – whether the hospital is community owned investor owned.
The expansion of board responsibility in health care expands beyond hospitals into all stakeholders organizations within the health care systems. As the responsibilities of boards expand, board members are looking for ways to be more effective in their roles. In turn, managers are looking for ways to relate better to the requests of boards.
I currently serve on four corporate boards (none in health care) and have consulted over the years with numerous boards from both the for-profits and nonprofit sectors. Board members have little training and are confronted with issues of they had never thought of when they accepted their positions. Managing the boundaries of the board is a key issue. By boundaries I mean, the level of involvement board members should have within the organization. Sometimes board members are confused as to whether they are managers and/or consultants, as well as board members. Likewise, organizations are confused as to what role they expect boards to take.
David A. Nadler in the Harvard Business Review, May 2004, does a good job of addressing the issue of boundaries. His taxonomy of board boundaries ranges from passive participation through to operating the organization. Board members and their organizations should be clear in defining the desired level of involvement required. In my experience, not doing so is one of the biggest and most common hindrances to board effectiveness. Board members are most effective when they know the extent of their roles.