Testimonies abound about the value of the Willa Carson Health Resource Center, in North Greenwood, FL, but the small, popular, free clinic is on financial life-support. If an infusion of cash isn't received soon, the clinic--founded in 1995 by registered nurse Willa Carson to provide healthcare to the poor--could close in three months. The center has just $10,000 in cash. Its leaders are considering cuts to the clinic's $250,000 yearly budget.
Dr. Imad Almanaseer, a member of a powerful state healthcare planning board told political fundraiser Antoin "Tony" Rezko's fraud trial that he switched his vote on an $81 million hospital construction project partly because he felt embarrassed and humiliated by another panel member. Rezko, a key fundraiser for Sen. Barack Obama and Gov. Rod Blagojevich, and millionaire attorney Stuart Levine are accused of scheming to split a $1 million kickback for ramming the $81 million hospital project through the Illinois Health Facilities Planning Board.
Leslie Hirsch has resigned as president and chief executive of Touro Infirmary effective in early May. Hirsch came to Touro one week before Hurricane Katrina. He is leaving to serve as president and CEO of the Saint Clare's Health System in New Jersey. His resignation comes at a time of financial stress for local hospitals, which have absorbed waves of uninsured patients through their emergency rooms since Charity Hospital closed after the storm. He is the second hospital chief executive to leave the area in less than a year, joining Gary Muller of West Jefferson Medical Center.
Whenever I hear about a board-CEO battle that ends in a CEO's dismissal, I can't help but wonder how it went so wrong. After all, in theory, CEOs and their boards are focused on the same goal: the organization's success. Shouldn't that be enough to keep the relationship together?
Apparently not. As with all relationships, personal agendas, priorities, and egos can get in the way. So, what makes the difference between harmony and horror story when it comes to hospital leaders and their boards?
As I wrote last week, a large part of the CEO's job is maintaining that board-leader relationship. CEOs might be lulled into thinking that a quiet board--a board always in agreement--is a happy board. That's dangerous thinking, says James Orlikoff, a consultant specializing in healthcare governance and a speaker at this week's American College of Healthcare Executives annual conference.
As in a marriage, there's a fine line between comfort and complacency when it comes to your board relationship, and constant board consensus can be a sign of board apathy. Good boards, says Orlikoff, are "disruptive"--meaning they argue, disagree, and debate on their way toward making good decisions.
Orlikoff has a long list of things leaders can do to ensure their boards are "effectively disruptive." Here are some of them:
Executive sessions: Most CEOs aren't crazy about executive sessions, Orlikoff says, but it's far better for the board to be able to discuss problems in its relationship with the CEO early on before those issues become bigger problems that result in CEO turnover.
Executive sessions should be regularly scheduled at the end of every board agenda with set ground rules. Nine out of 10 times this meeting will be only three minutes long, Orlikoff says, but they'll give the CEO a chance to address problems and the board an opportunity to self-correct.
Board terms: Despite the fact that the best boards function on process and principles, a lot of boards still run on personality, Orlikoff says. This can get you into trouble. For example, you love your board chair so you don't set board term limits. But a year later, the chair leaves unexpectedly and you're stuck with a bad board chair--and no limits to save you.
Board terms force organizations away from personality-driven governance, Orlikoff says. He recommends organizations begin evaluating board members the year before their terms are up for renewal. This gives board members a one-year signal to improve performance.
Mini-evaluations: Mini-evaluations are "the highest yield, lowest cost improvement you can make," says Orlikoff. At the end of every board meeting, have board members complete a quickie evaluation about the meeting, the process, and the board in general. Your governance committee (not the entire board) should review the evaluations, aggregate findings, and adjust practices. Rather than make big, sometimes painful, changes every two years, make incremental improvements along the way.
Include an outsider (or two): Most boards are made up of several linked-in, high-powered community members, but Orlikoff recommends organizations include on their boards one or two outside, independent board members. These folks don't have any social or economic pressures clouding their judgment and might be more willing to say "the emperor has no clothes" when necessary, says Orlikoff, who serves on the board of Seattle-based Virginia Mason Health System.
When an organization complains of "problem board members," Orlikoff says, it's usually a case of a problem board. As a leader, it's your job to keep your board on track. The more things you can implement now to keep the relationship strong, the better your chances of knowing your board's in trouble before it's too late.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
Memorial Health System in South Bend, Ind., has made innovation at all staff levels a systemwide priority. In this interview, Vice President of Marketing and Innovation Strategy Diane Stover discusses why innovation is increasingly important in healthcare and how organizations can be more innovative.
The great employees will be devoted, sure, and it's completely reasonable to expect them to work their butts off. But unlike founders, employees are concerned about what their jobs are like today. They're not as excited about making sacrifices for the long run. So don't tell your star salespeople to take the bus and stay with relatives when they make that call in St. Louis, even though that's what you did when you started the company.
A planned three-day strike by nurses at Contra Costa Regional Medical Center in Martinez, CA, has been averted after negotiators and the union found common ground. The facility is operated by Contra Costa County, which withdrew its proposals for cutbacks in retirement plans and healthcare benefits, according to the union. A 10-day strike is still planned at Sutter Health affiliates in California.
The new nonprofit board of Grady Memorial Hospital in Atlanta has not been appointed yet, but potential members signaled they plan to move quickly to save the hospital. The nonprofit board will meet just days after being announced, and the first meeting will largely address organizational issues such as selecting officers and creating a task force to help with the transition of control.
Canton, GA-based Northside Hospital is seeking permission from the state to build a 75,000 square foot medical office building in central Cherokee County. Northside representatives said the building would be constructed on 6.26 aces of land in a densely populated area that would "provide easy access to primary care physicians and specialists to the community."
More than a year after Pennsylvania Gov. Ed Rendell tried to gain approval for a plan to provide healthcare coverage to nearly 800,000 uninsured state residents, a scaled-down version of his plan is moving through the General Assembly. The measure, expected to get final House approval, would provide coverage to close to 300,000 uninsured residents. The bill would extend malpractice-insurance subsidies by 10 years in an effort to keep doctors from leaving the state because of high premiums.
