Center Voices
Board Orientation: A Continuing Process
By Samuel A. Friede
Orientation should be viewed as the first step of the board’s continuing governance education (CGE), rather than simply a one-day introductory meeting or the provision of an information packet. A trustee’s ongoing educational process includes his or her recruitment, nomination, orientation and continuing education.
During the recruitment and nomination period, potential trustees should be introduced to the organization’s strategy as well as to their future governance responsibilities. Once exposed to board matters, incoming trustees are primed for orientation—a concentrated form of education comprising a broad range of information essential to governing a health care organization effectively.
The Orientation Meeting
Perhaps the most comprehensive component of a board’s overall education program is the formal orientation meeting for new trustees. Board orientation should include a wide range of information about both the health care industry and health care governance. Topics can include the fundamentals of delivering care from both a national and a local perspective; principles of effective governance; the relationship between the board and other organizational leaders, such as the CEO and physician leaders and executives; and the implications that broader governance reforms, such as the Sarbanes-Oxley legislation, have for hospital boards.
Current board members, the CEO and other members of the executive team should determine orientation topics, including the history, current status and future implications each topic has for the hospital and its key stakeholders.
A thorough grounding in important matters facing the industry and the hospital will help prepare board members to more effectively deal with the issues they will face and to participate more productively in strategic planning for, and leadership of, the hospital or health care system.
Boards often supplement their orientation meeting with a manual that includes key information about the organization as well as the board’s bylaws, policies, financial status and quality measures. The board manual should be given to every new trustee participant in advance of the orientation meeting.
A tour of the facility is an essential part of board member orientation. Too often trustees attend board meetings and discuss matters pertaining to areas of the hospital that they have never seen. Meeting the people involved and appreciating how services are delivered in the emergency department, surgical suites or an affiliated clinic brings a deeper dimension to board deliberations and is a necessary component of a comprehensive orientation.
Governance Education Continues
The principle of mentoring is as valuable in the boardroom as it is in the C-suite. As applied to governance, mentoring means pairing a seasoned trustee with a new trustee to act as a resource and advisor at the start of a new board member’s tenure. Included as part of a concentrated, formal orientation process, both mentoring and board self-evaluation can play key roles in the CGE effort. Board leaders and executives should encourage current trustees to serve as mentors.
However, the board should be thoughtful when implementing a mentoring program. Some new trustees may already be experienced in health care governance, so mentoring should be offered as an option, rather than a requirement.
Ideally, the CEO and board chair would work together to match new trustees with appropriate veteran board members. Monitoring mentor relationships periodically (in six months to one year) also allows both board leaders and new trustees to analyze the relationship’s value.
Finally, board self-evaluation supports and advances CGE by helping to identify ongoing opportunities for additional board education. For example, if an issue arises that some board members may not fully understand, but about which they are reluctant to ask questions, they can use the board self-evaluation process to ask for additional education on the topic.
Orientation Excellence
ACMH (Armstrong County Memorial Hospital), a 158-bed rural facility in Kittanning, Pa., and the much larger University of Pittsburgh Medical Center (UPMC) are both strong examples of organizations committed to ongoing board orientation.
As chair of the board’s continuing education committee at ACMH, I coordinate discussions on a variety of governance topics. The board chair, CEO and I review information on each topic and provide it to all trustees in advance of the board meeting. As a full board, we then discuss the implications of each issue for the organization. In this way, we frequently identify ways to improve our own governance practices.
In a different and innovative approach, UPMC board members are kept up to date with access to a protected Web site that contains organizational information, bylaws, minutes of previous meetings, financial statements and other items. This Web site also provides a link that takes trustees to previously presented education programs.
These examples show that, large or small, any hospital can provide continuing education for its board and help promote an optimal level of stewardship for the hospital and the community.
Samuel A. Friede, FACHE, is director of the Governance Initiative for the Health Policy Institute and assistant professor in the Graduate School of Public Health, University of Pittsburgh. He is also a trustee of ACMH. He can be reached at (412) 624-3675 or at friede@pitt.edu.
This article 1st appeared in the December 2099 issue of Trustee Magazine.
To respond to this article, please click here.
