Hospital governing boards are experiencing information overload. Data comes at them continually from within their institutions, regulatory agencies, third party payors, and a host of other stakeholders. To do their jobs, these boards need better ways to make sense of the information they receive.
Hospital governing boards are experiencing information overload. Data comes at them continually from within their institutions, regulatory agencies, third party payors, and a host of other stakeholders. To do their jobs, these boards need better ways to make sense of the information they receive. Unfortunately, however, because the information flooding the boardroom too often does not support their core governance function, many hospital trustees are overwhelmed, frustrated, and unable to effectively steer their organizations through the increasingly troubled waters of the healthcare industry today.
Most board information inadequacies are all too recognizable to the trustees of healthcare institutions. The real problem is that one is sure what to do about them. Some regard these failings as inherent to healthcare governance, as though poor information comes with the territory. Fortunately, this couldn’t be further from the truth. Inadequacies of board information can be addressed by following some basic tenets, outlined here. With some reorganizing, re-formatting, and streamlining of information, board members can spend less time struggling to understand their board packets and spend more time on the important work of really governing.
Let’s begin with where most organizations are today: mired in reams of excessive and unhelpful data. To start improving board information, we must first identify what’s wrong with current information. Listed below are the eight most common defects in governance information provided to hospital boards.
Information is often provided in indigestible quantities, requiring more time and expertise than anyone, particularly busy board members, can spend. The bulk of information may create the illusion of an informed board but it, in fact, often leaves the board disoriented and frustrated.
Inappropriate Levels of Detail
Data for healthcare organizations’ boards are often presented at too fine a level of detail. Excessive detail only creates and reinforces a tendency for the board to micro-manage the institution and distracts the members from their critical role of organizational governance.
A Non-Governance Perspective
Governance — often to a much greater degree than administration — requires consideration of mission and values, organizational liability, fiduciary integrity, long-range environmental trends, opportunities for inter-institutional collaboration, and the needs of sponsors and other publics. Information for the board that is merely a subset of the management information system can tend to underplay or totally ignore these governance concerns.
Lack of Strategic Relevance
Strategic issues are those that impact the viability of the institution — both in terms of mission and financial performance. Information, however interesting, that lacks a direct relation to such issues diffuses the board’s proper focus and has no place in the boardroom.
Individual Trustee vs. Whole Board Education
Providing specialized or detailed information to select board members can serve a valid purpose, but does not expand the whole board’s core knowledge base. Only the whole board is empowered to act on behalf of the institution. Information important enough for individual trustees should usually be provided to the entire board, as well.
Overly Time-Consuming Information
The special need for boards to use their time efficiently is not served through information flows that are excessive, too detailed, and/or tangential to governance concerns. The use of non-graphic formats or presentation techniques that make rapid understanding difficult also contributes to the waste of board time.
Reliance on the Anecdotal and Episodic
In the absence of predetermined and objective performance indicators, there can be a tendency for hearsay and inconsistently derived ""facts"" to surface. Such reliance on the anecdotal and episodic requires an inordinate amount of time and energy to substantiate or refute.
Lack of an Interpretive Context
Information is valuable only to the extent that it can be put to use for the benefit of the institution. Performance data that are reported without reference to some context — e.g., predetermined standards of performance (such as budgets) or performance in previous periods or comparable settings — provide an insufficient interpretive context upon which to base any advice or guidance.
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