Due to a number of significant events in healthcare over the past few years, it is apparent that a mandate for change in governance practices of healthcare systems has reached the top of the list of healthcare issues. Besides healthcare reform, “governance” is the topic de jour for most healthcare systems. While much has been written about the challenges and issues facing boards, best practices and some innovative approaches to good governance, less has been directed to practical solutions.

This article is the first in a series and will provide an overview of some of the more significant challenges facing health system boards; subsequent articles will address practical solutions. The goal of the series is to provide some practical steps that can be easily implemented to improve the efficiency and performance of health system and healthcare organization boards.