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Steer the Boat, Don’t Row It: Governing Board and Executive Responsibilities

Steer the Boat, Don’t Row It: Governing Board and Executive Responsibilities. WSHA 34 th Annual Rural Hospital Summer Workshop June 28, 2010 Phil Sandifer, FACHE The Lakes Group, LLC. “Steer, Don’t Row”…easy to say, hard to do. Lessons Learned from 8 Interim CEO Positions.

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Steer the Boat, Don’t Row It: Governing Board and Executive Responsibilities

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  1. Steer the Boat, Don’t Row It: Governing Board and Executive Responsibilities WSHA 34th Annual Rural Hospital Summer Workshop June 28, 2010 Phil Sandifer, FACHE The Lakes Group, LLC

  2. “Steer, Don’t Row”…easy to say, hard to do.Lessons Learned from 8 Interim CEO Positions Questions asked to Board, Medical Staff, Executive Team, Hospital Staff and Selected Community Members: • What skills/expertise are you looking for in the new CEO? • What three things are positive about your job/relationship with this organization • If you were Queen (or King) for the next 60 days, what 3 things would you change about the organization?

  3. Summary of Responses to Questions • Regardless of reason for CEO departure, respondents wanted to see improvement of “communications and relationships” between them and the new CEO • General perception that all managers and executives were not held accountable at the same levels, e.g. sacred cows, don’t rock the boat…primarily in clinical areas • Board members were perceived as not in touch with the community at the level expected • Some issues with non-participating board members and ‘one trick ponies’, e.g. clinical, union, individual focused complaint—primarily district boards • 3 occurrences of the Board complaining the CEO did not keep them informed and/or demanded action on agenda items without adequate discussion • Medical Staff/community perceived Board ‘rubberstamped’ any request by the CEO • Strategic plan goals/actions remained at high levels—management or staff not aware or held accountable for goal accomplishment

  4. Summary Responses Continued • 2 occurrences staff was afraid to provide input/constructive criticism to executive team—wide spread ‘fear in the workplace’-Board perceived as not caring or unaware • 1 occurrence of Board Bylaws not reflecting actual actions=3 CEO’s in 5 years

  5. Board/Board Member Responsibilities in Positive Executive Relationships • NIHO: Nose In, Hands Off! • Ask questions, state concerns as they arise, expect full board participation • Seek to improve its own performance • Know your “Stakeholders”, solicit their input—understand the hospital is not the ‘business’ • Be patient with the existing or new CEO, gain joint agreement on next 12-18 month goals early on • No surprises for CEO at Board meetings • Don’t allow ‘end around’ operational issues direct to Board by staff/community

  6. Board/Board Member Responsibilities Continued • Minimize ‘rear mirror’ focus at Board meetings, look forward and expect responsibility/accountability from the Executive Team • Establish job descriptions for Board Officers, Members and Board Committees • Jointly develop with the CEO a CEO performance evaluation/incentive plan and objectively complete it annually in an expeditious manner

  7. CEO Responsibilities in Positive Board Relationships • Lead the Board in understanding the changing external healthcare, community environments • Apprise the Board as to what Management is trying to accomplish in the long term • Assist the Board in developing ‘stretch’ strategic goals for management to accomplish to meet external/internal challenges • Provide the Board insight of and access to Executive/Management Team members, e.g. presentations at Board meetings; solidify the ‘team concept’ perspective • Assist the Board in identifying Stakeholders and their needs through objective data and surveys

  8. CEO Responsibilities Continued • Assist the Board in meeting the rapidly changing demands of information technology, social media, data sharing, etc. • Jointly develop policies to expeditiously respond to and inform Board of “bad news” or crisis events prior to media publication or public meetings • Assist the Board in developing agendas that focus on strategy and dashboard measurement of key areas, e.g. quality, finance, credentials, strategic goals, etc. • Ensure that issues/actions classified as urgent at Board meetings are backed up by objective data and define the consequences of not taking action at the first Board meeting discussed—no surprises for the Board at meetings!

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