Community hospital board members overseeing rural healthcare systems today face an unusual set of challenges. They are tasked with maintaining their hospital’s financial health and viability while adjusting oversight in response to the Covid-19 pandemic. Each new outbreak places unprecedented demands on healthcare organizations and the communities they serve. Key takeaways from the American Hospital Association’s 2019 Governance Report can make board performance more effective during trying times.

5 Things That Can Improve Board Performance During Stressful Times

1. Create A Strong Onboarding Process for New Members

It’s especially tempting to put community hospital board member placement activities on pause right now. Putting a strong onboarding process in place ensures new members have all the information they need to make informed decisions. These adjustments can help make the onboarding process easier for new trustees during the Covid-19 pandemic:

• Ask a seasoned board member to mentor new trustees and answer questions as they arise
• Have the board’s CEO schedule one-on-one virtual orientation sessions to educate new community hospital board members about the organization’s finances
• Provide a password-protected digital library so new trustees can download resources in PDF format to print out at home
• Create an educational webinar outlining the hospital’s history, mission, vision, organizational structure and values
• Send new trustees an online survey asking them to evaluate their experience after six months

2. Implement A Continuing Education Requirement

The 2019 AHA Governance report shows more than 70 percent of boards have no continuing education requirements. Yet ongoing education can provide a wealth of benefits that increase board effectiveness as well as engagement, including:

• Community hospital board members gain essential skills, knowledge and behavioral competencies that are critical for good governance
• Helps members from diverse backgrounds make sound, responsible and well-informed healthcare policy decisions
• Understanding current liability exposure and legal compliance issues can help memberspotentially avoid any conflicts of interest
• Without informational items on the agenda, board meetings become more productive, efficient and to the point

3. Create a Succession Plan for the Community Hospital Board CEO

Nearly half of all AHA respondents surveyed also had no formal CEO succession plan in place. But in these uncertain times, it’s crucial for hospital boards to prioritize executive leadership development. When community hospital board CEOs leave suddenly with no successor, it can severely disrupt the organization’s progress. Implementing a solid succession plan can provide community hospitals with some crucial benefits during the current pandemic:

• Allows community hospital board members to vote on or approve the CEO’s potential successor
• Emphasizes the CEO and board’s strategic partnership roles in executing a shared vision
• Provides continuity of leadership in the event of a sudden or unplanned departure
• Prioritizes the organization’s financial health and viability above everything else

4. Clearly Define the Board’s Membership Roles & Requirements

Too often, community hospital board members blur the lines between governance, management and operations. It’s important to keep the board focused on developing effective strategies and let hospital leadership handle the execution. Posting clearly defined job roles and requirements when recruiting new community hospital board members can help eliminate organizational dysfunction. Clearly defined roles and responsibilities can also reduce board turnover while increasing membership diversity. Thankfully, 66 percent of AHA respondents indicated they had job descriptions for board members, board chairs and/or committee chairs.

5. Ensure the Board’s Composition Includes Some Outside Members

Outside board members can provide independent perspectives and valuable expertise not found within the hospital’s service area. It’s important enough that the AHA now considers outside community hospital board members a best practice for good governance. Unfortunately, AHA survey respondent data shows most boards are still predominantly older, white and male. Yet board culture can also produce more honest assessments and swifter action in response to today’s rapidly changing healthcare environment. Avoiding conflicts of interest can be particularly challenging for trustees serving on smaller, more rural hospital boards. Bringing in outside members can help boards avoid this common issue and help keep hospital leadership accountable.