Hospitals today are intently focusing on redefining the “H” — that is, exploring what it means to be a hospital in a rapidly transforming health care environment. Redefining the “H” also includes a component of redefining the “G” — determining the changes necessary to ensure that a hospital’s governance structure will provide purposeful, productive leadership well into the future.

Now is the time to redefine the roles and expectations of our hospital and health care system boards in providing leadership excellence and engaging multidisciplinary teams within the organization. Such teams should include physicians, nurses, volunteers, patient advocates and others while also connecting with diverse community stakeholders for their insight. Trustees of hospitals and health care systems will be responsible for fostering collaboration, supporting changes that likely will occur during these dynamic times and translating such change into positive action and outcomes for the community.

Empowering Boards: New Skills, Tools and Partnerships

Redefining the “H” will require hospitals and health care systems to equip their boards with new skills and tools and empower them to make difficult decisions. Boards must:

• stay connected and be able to translate the health needs of their communities

• assess possible partnership opportunities for better integrated, more coordinated care across all care settings

• serve as a liaison between the hospital and the community, and lead the hospital to be a convener of community stakeholders

• lead the organization to take the necessary steps and adapt in a changing health care environment

Four Steps for Uncertain Times

The American Hospital Association’s 2014 Committee on Research and Committee on Performance Improvement jointly released a Leadership Toolkit for Redefining the H, based on feedback from approximately 1,100 board chairs and C-suite leaders.

As outlined in the Leadership Toolkit, trustees must work together to offer guidance and develop a high-performing culture. This requires moving beyond current high-performance governance practices and taking four bold steps:

1Develop trustees for the future. To govern effectively in the current and future health care environment, boards may need to look beyond the community and tap outsiders with specific expertise in transformational change. The Leadership Toolkit includes a competency-based board composition resource that describes skills and competencies now necessary for trustees.

2 Ensure the right high-governance dialogue. Continual governance dialogue should be future-focused, visionary, adaptive and innovative. A section of the toolkit, Creating the Right Boardroom Conversations, outlines governance conversations that meet these requirements.

3 Commit to continuous trustee education and knowledge building. Trustees need a strong grounding and awareness as well as a solid connection to and understanding of the community and patients they serve. A diverse, well-informed, highly knowledgeable board is a CEO’s most useful asset.

4 Have courage to make difficult decisions. To manage change in uncertain times, boards must ask the right questions, disagree agreeably, challenge the status quo and willingly leave their comfort zones.

As our nation’s health system undergoes a transformation and as hospitals are redefined, patients and communities must see our steadfast dedication to health. This can be demonstrated through our organizations’ commitment to governance and leadership excellence and a commitment to being collaborative partners in our communities. 

To access the Leadership Toolkit for Redefining the H, go to www.hpoe.org/resources/hpoe hretaha-guides/1787.

Jonathan B. Perlin, M.D., chair of the American Hospital Association board of trustees and 2014 AHA Committee on Research, is chief medical officer and president of clinical services at HCA, Nashville, Tenn. Thomas W. Burke, M.D., chair of the 2014 AHA Committee on Performance Improvement, is executive vice president, Cancer Network, at the University of Texas MD Anderson Cancer Center, Houston.