In this Insight, Proximity suggests hospital board education may be an under-leveraged strategic lever for hospital CEOs. This comes with a caveat, however. Approaching board learning with heightened strategic intention, if not well-framed, can boomerang.
When deployed with strategic intentionality from the desk of the hospital CEO working in allyship with the Governance Committee of the Board, board learning is a powerful lever at the disposal of every hospital leader. Done well, it has the potential to well-inform board dialogue and decision-making, further the strategic progress of the hospital corporation and foster CEO-board trust on priorities that matter most.
In a survey undertaken by Proximity, governance professionals identify two primary sources that inform board learning choices. The first is foundational technical governance instruction on the nuances and peculiarities of the Ontario hospital sector. OHA’s Governance Essentials program and Guide to Good Governance are good examples that contribute to foundational sector understanding. Many hospitals integrate this nature of foundational material into their board orientation packages and briefings.
A second feeder for board education is topics of interest generated by volunteer boards themselves. The treatment of these topics varies and it can be tricky to deliver sufficiently precise and relevant content that has the pragmatic value to inform or enhance board understanding for decision-making.
Proximity suggests the existing approach to board education (technical governance and board-generated topics) fails to do justice to the nuanced complexity of the Ontario health sector in which hospitals operate and volunteer boards are tasked to oversee. A potential lag in board understanding is further compounded by health system opacity combined with the onslaught of challenges and opportunities such as AI, primary care, eldercare, and more.
Eking out greater value from board learning
The wizardry of truly effective board learning is derived out from approved hospital strategy. Effectiveness lies in both intentionality and advance planning. Effective board learning sows the seeds of knowledge and understanding with a board leading up to an impending strategic inflection point and critical strategic decision juncture on which directors will be invited to deliberate. With this outcome in mind, board education becomes a powerful strategic asset in the hands of the CEO and Governance Committee and reduces the lag in board knowledge of factors and considerations specific to their governing mandate.
There are, however, two tricky bits to consider. The first is timing. Board learning initiated too far in advance of a critical decision juncture may fall short of its desired aim by creating too much of a hiatus between the learning and decision requirements. The reverse holds true as well. Board learning crammed in at the eleventh hour may muddy rather than enlighten and be construed by directors as poorly planned.
A second tricky bit for the CEO is clarifying the strategic aim of board learning as it relates to an impending complex governance decision. This is a very targeted use of board learning and differs, for example, from a general educational session or backgrounder on a current topic. The risk of failing to effectively set up the board learning intervention, its context and aim runs the risk of boomeranging both as a lost or wasted opportunity for the CEO as well as potentially leading the board down a divergent path. One CEO also suggests properly credentializing the professional expertise brought to bear for strategic board learning, whether the expertise is sourced internally or externally. This contributes to reinforce the strategic learning narrative and alignment which differs from more generalized board education.
Here are a few approaches a hospital CEO might consider in concert with their Governance Committee to catalyze board learning with enhanced strategic intentionality:
The CEO should oversee the construct of board learning in allyship with the Governance Committee
Intentional consideration, deliberation and planning to design precise and impactful board learning that contributes directly to furthering organizational strategy cannot be effectively delegated. The CEO must of course consult with the Board Chair and co-opt the governance professional to execute with excellence, but the impetus for educational choices and the manner in which board learning is designed and delivered is most effectively catalyzed by the CEO as it is a strategic lever.
Board learning agendas should emerge directly from the strategic agenda (internally generated)
The sector is fast paced, the context evolving, innovation and technologies are advancing at warp speed. Board education is best driven out from the forward-looking strategic requirements of the hospital with a strategically integrative logic, rather than approached as a set of discrete topical inputs. Board learning that is tightly aligned to the organization’s strategy ends up being strategically beneficial to both Board and CEO.
Board learning is planned, intentional and forward-looking in quarterly, six-month or at most, one-year horizons
The CEO should ask: “What critical decisions will I be asking of my board in the coming quarter, six months, year”? Based on the answer, education can be intentional and planned to ensure sufficient runway the Board needs to digest, query and reflect on the issues that the CEO will bring forward for decision in the not-too-distant future. This intentionality fosters CEO-Board allyship and ensures a volunteer board is well-informed for its oversight mandate. Better-informed boards ask better and more precise questions which are of high value to forward-thinking CEOs.
The board learning objective (desired outcome of board education) is the starting point of planning a board education agenda
Starting points to consider:
- “What does the Board need to understand that will contribute to its effectiveness as a tailwind for the organization”?
- “If the Board gets out front in its understanding of “X” (fill in the blank), then the hospital will benefit in spades from the brain power and experience around the board table”.
Meaningful and instructive board learning embraces possibilities beyond powerpoint presentations delivered at the boardroom table
Thoughtful board education aligned with strategic intention might include hallway and hospital campus tours and visits – less as show and tell – and more with an eye to support the board in its governance mandate and impending decision junctures. One hospital speaks to ‘tracer groups’ – well-planned and guided deep dives into key areas of the hospital, often tracing or shadowing the journey of real patients through the system. This moves what can be abstract discussion in the boardroom to tangible understanding of what’s at stake and how it all works. Another CEO invited directors to sit for two-hour increments in the ER to observe and chat casually with patients and staff, while yet another sent directors on the equivalent of an easter egg hunt to “discover” the hospital, meet staff, and better understand the inner workings and challenges.
Board learning needs a rethink. In the hands of a savvy hospital CEO, board education is an exceedingly potent and creative strategic asset. And for savvy board directors, strategic board learning raises their effectiveness in their governance mandate.
