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Hospital Board Advisory
Board Communication, Teamwork, Spell Success at Yoakum Community Hospital

by Karen Barber, CEO, Yoakum Community Hospital


Leveraging Resources for Change


When I joined the Yoakum Community Hospital team in 2006, one of the biggest hurdles I faced was improving board-management relationships. I realized that addressing this challenge would be essential to paving the way for a better, more secure financial and operational future for the hospital and community. Elorine Sitka, Yoakum Board Trustee and Chair, shared this vision, and together, we turned ideas into reality.

As a 25-bed critical access hospital in rural Yoakum, Texas, it became apparent that trustees had not been receiving all the information they needed — in a timely way — to make well-informed decisions. We realized that trustees were challenged in performing their basic fiduciary and financial duties, and change was necessary to inspire and create a high-performing board dedicated to the hospital’s success.


As partners, our goal was to improve the hospital for the good of the community. We developed recommendations on ways to improve board relations and engagement – laying a solid benchmark for success for many rural hospitals.


Five Steps to Success


Certain basics are “must-haves” for continuous improvement in board-management relationships, including:


1. Clarify expectations regarding roles and responsibilities

Governance and management are distinct functions. At Yoakum today, board members view their role as strategists and overseers. They leave management and operations to hospital leaders and managers, although that wasn’t the case previously. Board members provide direction. Managers create and implement tactics to support board strategies. One significant consideration is to provide board members with updates to keep them in the loop.


Identifying specific responsibilities in written form can also help prevent confusion related to roles. Discussions about mutual expectations are important, too. What do trustees expect of the CEO? What types of things can a CEO do without prior board approval?


2. Foster open, consistent communications

Regular, informal phone calls and a weekly newsletter are great tools to keep board members informed. An online portal provides members with meeting materials to review at least a week in advance. Trustees are encouraged to reach out to leaders if they have a question or concern, as well as participate in meeting discussions and respectful debates.


3. Make meetings purposeful

Make board meetings organized and action-oriented. Take informational items off the agenda for trustees to read on their own. Focus face-to-face time on several major issues that require voting at board meeting time.


I strongly suggest that everyone “stick to the agenda.” The entire team is busy, so keep meetings short and on point. And set aside time to socialize. Sharing a meal together before getting down to business inspires fellowship and teamwork.


4. Create resourceful onboarding and continuing education

New trustee orientation is vital and should include meetings with key stakeholders, including the CEO and CFO, as well as important partner organizations. A tour of the hospital and distribution of educational materials including an organizational chart and a glossary of healthcare industry terms and acronyms are part of the process.


5. Identify potential trustees

A specific recruitment process for new trustees is key. At Yoakum, we maintain a running list of potential board members, keeping in mind leaders and colleagues with diverse backgrounds. Another consideration is to identify potential board members without any sort of personal agenda. The focus should be on improving the hospital for community health.


We also encourage board members to listen to presentations offered by hospital staff, and take advantage of state and other sponsored trustee education programs. At Yoakum, we also invest in an annual board retreat and involve trustees in monthly birthday celebrations and other hospital events.


Building on Success


Looking back, the difference at our board meetings today is obvious. Today we have a strong board and dependable, trustworthy leadership committed to a common purpose.


To learn how Yoakum Community Hospital developed a high-performing board, read this CHC case study.

Tags: Hospital Board Advisory, Hospital Performance Improvement, Operational Improvement, Strategic Direction
Building Successful Hospital-Board Relationships

by Craig Sims, SVP, Southwest Hospital Operations, CHC


Community-based hospitals put the “care” in healthcare, and

meaningful hospital-Board partnerships based on trust and mutual goals drive this mission. Board members make important decisions to serve the community , and help develop strategies to ensure the hospital’s long-term sustainability.


Here are some best practice tips for positive, productive Board-CEO relationships.

  1. Develop a Trustee recruitment and retention process. Recruiting and retaining Trustees is too important to be left up to chance. In fact, “retention” begins in the recruitment phase and never ends. Initial orientation for new Board members should include one-on-one time with the hospital CEO and CFO, as well as the Board Chair and Finance Committee Chair. After six months, ask Trustees about their orientation and education experience. Seek ways to improve.
  2. Foster open communication. Communicate with candor. Facilitate two-way dialogue and encourage open communication. Create an environment of trust to help everyone tackle tough decisions. Even if there are dissenting opinions, a collegial atmosphere allows Board members to say to one another, “I value your input — tell me more.”
  3. Communicate frequently with Board members. Share timely information on hospital and community events, along with local, regional and state issues impacting health care. Provide educational articles and links, send out Board packets in a timely fashion prior to Board meetings, and utilize current technology to facilitate communication (electronic Board packets and Board portals, for example).
  4. Make meetings meaningful. Start with the “why” instead of the “what.” Begin Board meetings by reading the mission, vision and values of the organization instead of jumping into reports. Productive meetings require engagement; move informational items off the agenda for Trustees to read on their own. Focus on three to five issues that require voting. In closing the meeting, the Board chair should ask the group:

    -     Did we focus on the right issues?

    -     Did we participate in an active way? 

  5. Understand the difference between governance and management. The role of the Board is governance. The Board governs and sets policy; hospital administration manages and implements policy. Hospital Boards should focus on strategy, not operations.
  6. Facilitate continuous learning. Effective boards are well-educated. Budget for Board education, including learning opportunities such as:
    -     Comprehensive Board orientation
    -     Annual Board self-assessment
    -     Planned continuing education
    -     Board retreats

 CHC offers a variety of advisory services depending on client needs — including board education — to help enhance hospital CEO-board relationships. Learn more about CHC Hospital Board Advisory Services

Tags: Hospital Board Advisory, Hospital Performance Improvement, Strategic Direction
Cindy Matthews: trustees as health advocates for "Community Health and Relations"

Cindy Matthews shares perspective on how governing board members can help improve "Community Health and Relations" in this Trustee Online education module available through Texas Healthcare Trustees.


Preview this module and learn more about THT distance learning programs.


Tags: Hospital Board Advisory
CHC Prescription for Board Competency Featured in HealthLeaders Magazine

At a time when hospitals are under extreme pressure, only 66 percent of CEOs consider their boards strong or very strong and 11 percent consider them weak or very weak, as published in HealthLeaders Media Industry Survey 2013. Many boards simply aren’t up to speed on all the forces at work in the current healthcare climate, including the Patient Protection and Affordable Care Act. Boards require education to make sense of these challenges and assess the long-term viability of their organizations.


CHC Consulting, the management and consulting arm of CHC, works with hospital boards on education as well as strategic vision. CEO Mike Williams shared best practices for hospital boards in the May cover story of HealthLeaders magazine, “Building Better Boards,” including:

  • A longer commitment by board members of three, three-year terms
  • A robust quality committee with multidisciplinary clinical representation
  • More active and vocal audit and compliance committees
  • Placing more accountability on the CEO
  • Engaging in advocacy efforts and dialog with elected officials  

Read the full article here.


Learn about CHC’s Board Advisory Services here, and call us to assist your hospital board and management with strategic decisions that affect your hospital’s future.

Tags: Affordable Care Act, Healthcare Reform , Hospital Board Advisory
CHC webinar recap: Evaluating partnership opportunities

A Jan. 30 Becker’s Hospital Review webinar presented by Mike Williams, president and CEO of Community Hospital Corporation (CHC), offered best practices and a case study for community hospitals looking for a partner. 2012 saw the most merger and acquisition activity among hospitals in two decades, Williams said, and the trend is expected to continue in 2013 as many community hospitals — faced with healthcare reform, decreasing reimbursements and other challenges — acknowledge the need for some type of partner.


The case study presented by Glenn Robinson, CEO of Hillcrest Health System in Waco, Texas, demonstrated how Hillcrest Baptist Medical Center saw significant improvements —including the strongest financial year in its history — after partnering with Scott & White, with guidance from CHC.


When considering a partnership, community hospitals first must assess their needs and potential gains in seven key areas:

  • Community need
  • Clinical service breadth
  • Physician alignment
  • Revenue
  • Managed care leverage
  • Compatibility of purpose or mission
  • Reputation

Read the entire Becker’s Hospital Review article here.


Download a recording of the presentation here.


Download the PDF version of the presentation here.

Tags: Hospital Board Advisory, Independence, Partnership, Strategic Direction

CHC in the Spotlight