Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals

Governing in the Context of Health: a global perspective

Posted on January 26, 2016 by James A. Rice, Ph.D., FACHE


In the North America and Europe,  tax-exempt hospitals have benefited from boards composed of community leaders who generally volunteer their time and expertise to enhance the performance of one of their community’s largest employers and essential contributors to the health and well being of the community and its employers

That is not the case in many low and middle income countries in Asia, Latin America and Africa. To explore our prior work to develop good governance practices in Africa, we include a series of blogs here that provide insights into the challenges faced by these hospital governing boards. The first resource is a web based educational program being used by health systems managers and board members in Asia, Latin America and Africa

You can Learn “Governing in the Context of Health” in Eight Hours in a new USAID Unveiled Governance and Health eLearning Certificate Program. To register for the program click here.

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Can Health System Boards Learn from University Boards?

Posted on January 13, 2016 by James A. Rice, Ph.D., FACHE

In a recent landmark report from the National Commission of College and University Board Governance,[1]   we find seven important recommendations to enhance the effectiveness of good board work. As we explore these seven imperatives, consider how they can also stimulate health systems’ boards to raise the bar on their own performance in the changing situations for hospitals and health services delivery

  1. Boards must improve value in their institutions and lead a restoration of public trust in higher education (aka hospital care).
  2. Boards must add value to institutional leadership and decision making by focusing on their essential role as institutional fiduciaries.
  3. Boards must act to ensure the long-term sustainability of their institutions by addressing changes finances and the imperative to deliver a high-quality education (aka health care) at lower cost
  4. Boards must improve shared governance within their institutions through attention to board-president relationships and a reinvigoration of faculty (aka medical staff) shared governance.
  5. Boards must improve their own capacity and functionality through increased attention to the qualifications and recruitment of members, board orientation, committee composition, and removal of members for cause.
  6. Boards must focus their time on issues of greatest consequence to the institution by reducing time spent reviewing routine reports and redirecting attention to cross-cutting and strategic issues not addressed elsewhere.
  7. Boards must hold themselves accountable for their own performance by modeling the same behaviors and performance they expect from others in their institutions.

Perhaps our health systems’ board members should meet periodically with their university board colleagues to share ideas about how best to leverage the time and talents of community leaders for stronger board work for stronger organizational performance?


[1] “Consequential Boards: Adding Value Where it Matters Most,” Association of Governing Boards , of Colleges and Universities, Washington DC 2014

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