No matter what a person's organizational role, continuing education is important. For policymakers, it's essential. That's why board education is a critical component of effective governance at Sharp Mesa Vista Hospital, a mental health hospital in San Diego.

The more knowledge trustees have, the better it is for the organization. Our board members come from a variety of professions — they are attorneys, bankers, professors, clergy and engineers — but most do not have expertise in health care. Several physicians serve on the board, but like our other trustees, they have limited knowledge about the hospital's operations and governance.

Hospital board members receive education through:

  • a formal orientation program,
  • board retreats, and
  • educational sessions at board meetings.

Ongoing educational sessions at board meetings allow us to accomplish several objectives.

The board convenes every other month, and hour-long educational sessions are conducted at each meeting. Trustees and management agree on topics in advance, and most sessions address hospital operational issues or overall health care trends. The sessions have focused on accountable care organizations (Sharp HealthCare is a Pioneer ACO) and the medical staff credentialing process.

Board meeting educational sessions also help the board track the impact of its decisions. For example, a year after the board approved an equipment purchase for our cancer center, trustees learned that the anticipated return on investment in the equipment had been achieved.

Some board meeting educational sessions give trustees insight into the types of illnesses our hospital treats. For example, one of our physicians explained to the board the disease process of chemical and alcohol dependency from a scientific and quality perspective. This presentation not only benefited the full board, but also allowed a physician trustee who was not that familiar with the process of addiction to take this knowledge back to his own medical practice.

Informed Understanding

As health care organizations focus on improving value for their stakeholders, boards are spending more time learning about and overseeing quality of care and patient safety. Trustees are concerned when they hear that a patient experienced an adverse event as a result of a medical error, such as receiving the wrong medication, and they want to know how that could happen at their hospital. They may listen to reports about negative events at board meetings and not fully understand why they occurred.

Through regular education, however, trustees begin to understand that mistakes occur, mostly due to poor processes, but sometimes as a result of human error. Understanding the causes of poor quality and safety can move board conversations beyond punishment and blame to focusing on making performance better. Educated boards also understand their own responsibility for ensuring that organizational culture supports safe, high-quality patient care and that the hospital uses tools and processes to continuously improve care quality and safety.

Educated board members expect their hospitals to be transparent about organizational performance. Sharp Mesa Vista reports its quality data, including adverse outcomes, to the board. We use a dashboard report that color-codes levels of performance on quality and safety measures, which prompts board members to ask questions about why performance varies from hospital targets and what staff are doing to address the variation. Trustees must understand that a plan is in place to move outcomes to top-tier performance. Providing national benchmarks also gives board members a tool for comparing and evaluating hospital performance.

The real payoff from board education comes when trustees apply what they have learned. Asking the tough questions at board meetings, holding themselves and the organization accountable and responding knowledgeably to questions they are asked in the community are just some of the ways educated trustees demonstrate their value as partners in hospital governance and leadership. T

Kathleen R. Lencioni, FACHE (, is CEO of Sharp Mesa Vista Hospital in San Diego.