The measure of board retreat success can be summed up in one simple statement: “That was a good use of my time.” Developing retreats that leverage leadership time and resources and deliver meaningful outcomes requires advance planning and preparation, as well as follow-up after the retreat.

Plan with Purpose

Successful retreats give trustees the opportunity to distance themselves from day-to-day business and set the stage to focus and deliberate in ways a regular board meeting doesn’t allow.

Board retreats should be planned around a specific purpose, such as identifying a strategic direction; strengthening community services and benefits; developing strategies to improve population health; assessing competitive position and market share; evaluating delivery of services along the continuum of care; or consideration of mergers, acquisitions or other joint ventures. Despite the range of potential topics, the purpose of the retreat should be limited to addressing only a few issues — those with the greatest strategic priority and importance.

Defining the purpose and setting the agenda generally is the responsibility of the board chair and CEO. However, most successful retreats incorporate the thoughts and ideas of other trustees, the medical staff and the executive team. An online survey or brief interview in advance of the retreat can help to clarify opinions and identify the most critical issues facing the hospital or health system, rate the effectiveness of current strategies, and identify objectives to be accomplished at the retreat. The results of this research should be helpful in defining the retreat purpose, setting the agenda and creating a starting point for discussions about specific topics.

After the board chair and CEO have gathered input and defined the purpose, they should set the agenda. The most effective retreat agendas not only build in generous time for dialogue, but are also flexible enough to allow participants to pursue open-ended discussions and explore unexpected ideas.

Gather Evidence

Too often, boards rely on anecdotal or insufficient information to make decisions. Once the CEO and board chair have determined the retreat’s purpose and agenda, they should identify where knowledge gaps might exist and what information will support and validate the work conducted at the retreat. Current data, relevant articles and other pertinent materials should be provided to participants well in advance of the retreat. Trustees should plan to review the materials and arrive at the retreat not only prepared to engage in constructive conversations, but to have in hand the information needed to make critical decisions. Presentations by executive management and outside subject matter experts early in the agenda also will contribute to trustees’ understanding of complex issues.

Encourage Dialogue

Armed with an understanding of the issues, trustees should be prepared to engage in robust, productive dialogue.

Depending on agenda topics and the number of retreat participants, it may be beneficial to use breakout groups to discuss issues in more depth. Smaller groups allow more individuals greater opportunity to voice their thoughts, and reticent members often find smaller groups a more comfortable setting in which to speak up.

If breakout groups are included in the agenda, a discussion guide should be developed for each group to stimulate the group’s thinking. It should include the topic to be discussed, specific questions to be answered, and the outcomes or recommendations to be achieved from the groups’ discussions. Allow ample time for breakout groups to discuss the issue and explore innovative alternatives. To enable the breakout group’s effectiveness, each group should appoint a moderator to facilitate discussion and a recorder to take notes. Following the breakout sessions, the full group should reconvene for moderators’ reports on group recommendations and full group discussion.

Breakout and full group discussions may generate a long list of recommended actions and potential strategies. For the organization to effectively focus its time, energy and resources, retreat leaders must incorporate a way to prioritize the most relevant and viable ideas, actions and strategies to be pursued. Competing priorities will only hinder the organization’s success.

The board should communicate its priorities and expectations for achievement to the executive team.

Evaluate the Event

Conducting an evaluation at the end of the session encourages participants to share their opinions about the effectiveness of the meeting, and provides feedback to improve subsequent retreats. A typical evaluation may ask participants to rate specific components of the retreat, such as the overall organization and flow of the meeting; value of the pre-retreat materials; overall participation, interaction and dialogue; value of the retreat in addressing the most important issues; and overall success of the retreat in prioritizing and developing a working consensus on goals and strategies. In addition, the retreat evaluation may ask open-ended questions, such as the most beneficial outcome of the retreat, ideas for future retreats, and whether the retreat was a good or valuable use of participants’ time.

Building on the Discussion

When critical issues and strategies are discussed and prioritized, a brief follow-up survey can help to further clarify retreat participants’ opinions and create a road map for next steps. For example, the top 10 most critical strategic issues may be identified at the retreat, and a broad range of ideas for strategies and objectives to address those issues may be developed. But deeper analysis may need to be done, such as determining the implications of the issues, the urgency of strategy implementation and the resources required. The hospital or health system may want to initiate a follow-up discussion or a survey that solicits further input from the board, administrative and medical staff leaders.

Successful retreats don’t end when everyone returns home. Recommendations and decisions must be addressed. It is the administration’s responsibility to create an action plan with timelines and indicators for tracking progress and accomplishments. Progress reports on issues that required further evaluation or assessment should be shared. Only then can trustees truly consider the retreat a valuable use of their time. 

Cindy Fineran ( and Nicole Matson ( are senior consultants at the Walker Co. Health Care Consulting LLC, Wilsonville, Ore.

Sample Pre-Retreat Questions

Consider using the following categories and questions when gathering trustee perspectives before a retreat.

SWOT Analysis

• What are the organization’s three greatest strengths? What can we do to maximize these strengths?

• What are the organization’s three most significant weaknesses? What can we do to minimize or eliminate these weaknesses?

• What are the three greatest opportunities on which the organization may capitalize (e.g., community relationships, partnerships with other providers, information technology and service expansion)? What can we do to successfully capitalize on these opportunities?

• What are the three most significant threats facing the hospital (e.g., regulation, competition and workforce shortages)? What can we do to eliminate or minimize these threats?

Mission and Vision

• Will our mission and vision continue to be appropriate and viable in two to four years? 10 years? If not, how do you believe the mission and vision should be different?

• Do you believe the successful achievement of these goals will result in attaining our mission and vision? If not, what goals do you believe are missing, and that should be incorporated into our strategic thinking?


• What do you want to accomplish at the retreat?