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Expertise from the Outside

Carrie Vaughan, for HealthLeaders Magazine, December 11, 2008
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Hospitals are structuring advisory boards to provide critical strategic analysis at minimal cost.

Healthcare organizations look to other industries for advice on everything from safety to finance to consumerism. For years, hospitals have been placing people with different business backgrounds and skills on their governing boards. Some CEOs have even managed to lure away executives from other industries to join their organizations.

But you can only have so many senior leaders, and governing boards can only have so many members. Even organizations that import knowledge and talent from other industries still may not have the range of expertise necessary to succeed in the increasingly complex industry that is healthcare.

Some hospitals are discovering other ways to grow their knowledge base besides expanding the C-suite or adding to an already bloated board of directors, however. Recruiting "experts from the field" to join their board committees?not as trustees, but as consultants?enables organizations to take a focused look in a specific area and gain a deeper understanding on that topic, says James Conway, senior vice president for the Institute for Healthcare Improvement. And still other organizations are establishing advisory boards of successful business leaders who share their expertise free of charge.

Mark Laret, CEO of UCSF Medical Center in San Francisco, falls into that camp. Laret decided to establish an executive advisory board eight years ago because of UCSF Medical Center's unique governing board structure. The regents of the University of California delegate the governing responsibility down to the chancellor of each of the 10 campuses?five of which have medical centers, Laret explains. "I can get quick board feedback, but it doesn't provide the breadth of opinion and critical analysis and assessment of our operation," he says.

Laret's board consists of seven renowned business leaders and meets every other month for about three hours. The meeting begins with a half-hour presentation about a new clinical program at the institution or a faculty recruit, followed by a standard financial and operational review of the organization. But the bulk of the meeting is focused on one or two strategic issues, Laret says.

Similarly, the Dana-Farber Cancer Institute in Boston was looking for additional ways to engage business and community leaders in the institution, so it established visiting committees roughly 10 years ago, says Susan Paresky, senior vice president for development.

Dana-Farber has five visiting committees with a sixth in the works. The visiting committees meet formally once a year and consist of 25 to 50 members, and most focus on a specific disease like hematologic oncology or gastrointestinal cancer. But they are not medical advisory boards, Paresky notes; they are focused on outreach and the business components of the organization. For example, they may offer recommendations or comments on marketing, the strategic plans of the centers that they visit, or advice on how to achieve the center's goals, she says.

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