How to Be an Effective Hospital Board: Governance & Leadership

Picture of Chip Holmes
Chip Holmes
Executive Vice President, Hospital Operations

A bit about me.

With a team, I provide oversight, service and support to more than 50 hospitals. In my role, I have worked closely with the boards of trustees and directors and the executive leaders for small and large hospitals in rural and urban settings for over 30 years. In an average month, I participate in 10 or more hospital board meetings.

Last month, for example, we celebrated the success of Wooster Community Hospital. We have had the privilege of collaborating with the Board and executive leaders at Wooster for almost three decades and we are so pleased and happy for the Wooster family and all the many quality and patient experience awards they have received.

“Wooster’s commitment to high quality, community healthcare is second to none. Our Octave family has had the privilege of serving WCH for nearly 30 years; we are all thrilled their comprehensive efforts to improve patient care and quality have been rewarded one more time.”

Hospital Boards: Responsibilities and Jobs

Hospital board members are the fiduciaries and stewards of the most important asset (I’m biased) in their community; they are legally responsible for everything that happens within the hospital. In my 30 years of working with hospitals, I have come to appreciate that the most effective boards focus on and role model three important duties:

  • Caring: That is, being prepared to be a board member today and every day by doing the homework and actively engaging in the work of the board. It is my belief that the next engaged and prepared person would make the same decision as any currently engaged and prepared board member.
  • Loyal: That is, other-centered, meaning they put the hospital and others before themselves, even when confronting compliance issues and conflict.
  • Obedient: That is, understand and follow the applicable federal and state laws as well as the hospital’s bylaws, policies and procedures and adhere to what your hospital subscribes to, e.g., Our hospital will be an accredited organization by The Joint Commission.

There are four critical aspects to the job of a hospital board member:

  1. Set the vision, mission and strategy. Answer the important questions of:
  • Where do we want to be?
  • What do we want to represent and what do we stand for?
  • What’s our strategy to get there?
  1. Engage with the hospital’s chief executive regularly and help the CEO be as successful as possible. Through the chief executive, you are serving the hospital and the community.
  2. Delegate, not relegate, the responsibility for care and the patient experience to the medical staff. Recognize that everyone in the continuum of care impacts the experience for patients. This means that the hospital is focused on service excellence, a safe and rewarding environment of care, modern technology, a progressive and contemporary clinical team, timely and relevant communication with patients, and much more.
  3. Consistently work to be the best possible board member and board, and at the same time, recognize that you are only a board when the board is together. At other times, you are often an ambassador and have a responsibility to bring those interactions and information back to the entire board.

To say I am passionate about hospital governance and leadership is an understatement. I look forward to sharing more best practices and learnings in a series of blogs we will be posting over the coming months.

In the meantime, take a look at these resources to support independent, community hospitals and their boards:

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