Jona Raasch, CEO of the Governance Institute in San Diego, which holds training sessions for boards on exactly this topic, says the number of hospitals with special quality committees has grown from 56% in 2005 to 70% in 2009, and this year she expects that figure to be as high as 80%.
Increasingly, she says, board members are tying executive compensation to performance metrics, and more and more, board members include patient stories—both good and bad—in their meetings.
Rulon Stacey, CEO of 450-licensed-bed Poudre Valley Health System in Fort Collins, CO, is chairman of the American College of Healthcare Executives.
“The intensity of what it means to be a board member has increased, “ Stacey says, “from [oversight of] the 990 filings to executive compensation to charity care to the increased focus on transparency. It’s everything. Because now the trustees have personal liability and personal risk because of recent legislative developments.” In general, he believes, the time members spend on their hospitals’ affairs, especially quality and safety, has increased by at least 40% and maybe 50% from what it was three years ago for many governing bodies.
Sean Patrick Murphy, senior vice president and general counsel to the approximately 1,000-licensed-bed Solaris Health System in Edison, NJ, says the need for a different kind of board member to govern many hospitals is becoming apparent. “We’re going to need talented, best-and-brightest young minds to step in where a bunch of retirees and socialites were, to spend their time to improve community health. And that means getting meaningful information in a timely manner, and being engaged. That’s a very different characterization of what most boards are today.”
In days to come, Conway says, one small way things are changing is that for some boards, “you now receive agenda and board materials a week in advance by courier, not when you walk in the room,” and members are expected to know the material before the meeting. “If you hear the ripping sound of the envelope being opened at the start of the meeting, board members will know that person is not fulfilling expectations.”