A report commissioned by the Parkland Health & Hospital System board of managers in Dallas makes a score of recommendations for improving governance practices at the troubled safety net health system.
The Parkland Health & Hospital System board of managers this week made public an outside consultant's report whose 20 recommendations include expanding the seven-member board to 11 members.
The report also recommends that board members at the Dallas-based public safety net system serve three-year terms instead of the current two-year terms, receive more training to better understand and perform their board duties, and that a "visitors committee" of outside observers serve as advisors to the board.
"These recommendations, taken together, provide a comprehensive road map for the board as we develop a sustainable governance model that is appropriate for a complex billion-dollar plus public safety net health system in the 21st century," Parkland Board of Managers Chair Debbie Branson said in prepared remarks.
The report was commissioned in May 2012 by the board, which hired The Saranac Group LLC consultants. Saranac issued the report in March, but the Parkland board put the report on its agenda this month, at which point the board voted to accept the report. The next step will be to start discussions on the individual recommendations, none of which have yet been implemented or rejected, Parkland officials said.
Some of the recommendations, such as the reorganization of board committees can be done through board action alone. Others, such as expanding the size of the board, will require legislative approval because Texas state law limits the size of governing boards for publicly financed hospital districts to no more than seven members.
"A great deal of research and reflection went into these thoughtful recommendations, and the board is committed to raising the governance bar for large and complex public safety net health systems," Branson said.
"It is about our professionalism, performance and accountability in fulfilling our oversight responsibilities. We will be more responsive to the needs of Parkland and its patients, as well as the expectations of the Dallas County community, that's the end-game here. We want to create a governance system that will serve Parkland well for generations to come."
The report comes as Parkland braces for a rigorous inspection this summer by surveyors from the federal Centers for Medicare & Medicaid Services, which was prodded into action after the February 2011 death of a patient in the hospital's psychiatric emergency department. The health system has been under a corrective action for more than two-years for myriad quality and patient safety concerns.
In 2011, CMS placed Parkland under a systems improvement agreement that allows it to continue to receive Medicare reimbursements as long as a third party is onsite to monitor and facilitate changes that need to be made.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.