We know when a hospital board chair’s term begins and when it will end. However, there is no one path to the finish line. Also, the path frequently changes as situations arise that cannot be anticipated at the start of the journey. Health care reform, competitive forces and changes in the executive suite are just a few of them. This essay explores the chair’s journey and the author’s views on how to make it a success.

The journey begins

In fulfilling its fiduciary responsibilities to the populations it serves, a board must be true to its mission. If it is to provide high-quality, compassionate care to the populations it serves, every issue considered and decision made by the board must have this mission in mind. While the mission may not change, the role of the board and its chair, and how they fulfill and advance the mission, must be a fluid process.

What to bring along

The chair’s journey is not meant to be easy, and it cannot be traveled alone. If navigated properly, however, it will lead to great success for the institution. The chair will need the following items with him on his journey:

A personal map.

The chair must figure out the best way to advance the institution’s mission. It is not a one-size-fits-all endeavor. If he is fortunate, his predecessor would have been the best chair the institution ever had. If the current chair is forward thinking and does what he should, his successor should be even better.

At the end of the chair’s journey, it will not just be a story about the money made or raised. Of course, these are likely to be critical to the institution’s success and are a necessity of health care in 2016. Rather, the chair should be judged by the number of people who were kept healthy and the number of people who were cared for and healed by the institution he served.

He also will be judged by the institution’s growth as an important resource within its service areas. Ultimately, his legacy will be measured by the institution’s ability, through future chairs, board members, management and clinicians, to continue to improve the quality of lives for generations to come.

The need to embrace change.

The chair is fortunate to have the opportunity to do something worthwhile under circumstances that never existed before and never again will exist. He is steering an institution in a unique moment in time; and while he should learn from the institution’s past, it cannot define what he needs to do. If the chair doesn’t embrace and drive change, the losers will be the populations served by his institution — those who depend on it for their care.

A consequence of embracing change and making difficult decisions is that he may not always succeed. However, he must help steer the institution in new directions that are critical to its success. We know that when we stand still in health care, we will fall behind those innovative institutions that are raising the bar on care and improving the quality of lives every day.

A great working relationship with the CEO.

Your CEO may have thousands of employees reporting to him. The board and the chair have one — the CEO. If you have the right CEO, you need to understand what he does, and if the board agrees with his approach, let him do his job.

The board is ultimately responsible for the quality and safety of the institution. The best way to fulfill this responsibility is to be sure your CEO works to raise the bar on quality and safety every day and give him the tools needed to succeed. Hold him accountable, measure what he does and reward his success. However, stay out of the executive suite and the operating room!

Thick skin.

The chair must wear an extra layer of skin on his journey. There will be people who do not embrace change. That is okay. He needs to explain what he thinks should be done, listen, be open to opposing views and build consensus. However, he cannot stand still. He has too much to accomplish as he navigates through the rapidly changing health care landscape.

Fellow board members.

The chair must have great fellow trustees. Together, they must establish a culture, provide the institution with stability, and make sure it is true to its mission. 

He will need many smart trustees with different points of view on the journey. He should not worry if they do not know a lot about health care when they join the board. If they understand their fiduciary role and are as committed as the chair, they will succeed. Also, a great thing about health care in the 21st century is that it is brand new. The issues forward-thinking boards are addressing today were not on anyone’s radar five years ago. While there is a lot to learn, those in the executive suite, and the consultants a board may hire, often are learning together with the board.

The finish line

At the end of the chair’s journey, he should appreciate having been part of something special. He should be honored to have served. If he did the right things, he will know that:

  • The institution is in a better position to fulfill its mission than it was at the start of his journey.
  • All who enter the institution know it is their institution and is there to provide for them. If this is not yet the case, the chair should know that he worked tirelessly to help achieve this objective and make it attainable by his successor.
  • If he waited for the population served by the institution to come to it when they needed care, he did not do enough.

In the new age of health care, the board, management and the entire institution must reach outside the hospital’s walls to meet the needs of those they serve, both in times of sickness and health.

The end of the chair’s term is the start of someone else’s journey. As the journey begins for his successor, the chair should know that he did his part to improve the health and quality of life of those his institution is there to serve.

Author’s note: The opinions expressed in this article are solely my own. I want to thank my fellow system, medical center and foundation trustees, a great management team, more than 2,000 employees, hundreds of volunteers and a great clinical staff, all of whom work collaboratively to deliver great health care to the populations they serve. I also would like to thank those who entrust their care to us, each of whom is deserving of the highest-quality compassionate health care.

Thomas C. Senter, Esq. (TSENTER@greenbaumlaw.com), is chairman of the board of trustees of Englewood (N.J.) Hospital and Medical Center and its parent system board.