Turning around dysfunctional boards
As the health care industry focuses its energy on trying to influence health care reform, it is sometimes easy to ignore the basics of leading a high performance organization. One fundamental activity for all organizations is governance and, unfortunately, this is frequently done poorly.
At the recent summer meeting of the Minnesota Medical Group Management Association my colleague, Professor Fritz Wenzel, provided a very useful overview of the characteristics of functional and dysfunctional boards of directors. He also outlined strategies to improve the performance of any board. As part of this presentation he also had a number of very specific recommendations to resolve common board problems. Here are some excerpts from his presentation:
Board effectiveness
Boards can be analyzed from four perspectives:
1. Process – How is board focus determined, how are decisions made, and how are meetings conducted?
2. Structure – What is the board composition, what are board roles and expectations, how are members oriented?
3. Behavior –How do board members act with the other board members, the organization and the external environment?
4. Performance – What is the board accountability for the organizational performance and what tools does it use to monitor execution?
Boards that pay attention to all of these questions will have superior performance.
Board Process Problems
Here are the top ten board process problems and some possible solutions:
1. Board attempts to micromanage – Clarify roles and keep focus.
2. Can’t make decisions and not united when they do – Formalize a decision matrix and create formal communications systems and deadlines.
3. Meetings last forever and are unproductive – Provide a formal timed agenda, document action plans and follow through.
4. Board members are recruited for the wrong reason – Establish criteria for board membership and formalize the process.
5. Roles are unclear – Document expectation and provide board education.
6. Board members lack organizational/strategic knowledge – Provide education and consider an external board assessment.
7. Members are not prepared – Call on members, revisit their role definitions.
8. Board practices “Group Think” – Assign a member to be “devil’s advocate” and institute board evaluations.
9. There are power struggles/factions – Deal directly and individually with members and heighten engagement of the total board.
10. A completely dysfunctional member – Options in increasing order of intensity: wait until term is over, off line discussions, neutral observer at board meetings, gracefully remove
Fritz Wenzel and his colleague Deborah Walker Keegan will present an extended workshop on this topic at the national Medical Group Management Association meeting on October 11-14 in Denver. If you are attending this conference, consider attending this session for a more in- depth look at this ongoing leadership challenge.