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Success stories at member organizations that provide lessons and opportunities for others to consider.

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Advancing Your Digital Health Strategy

View the accompanying toolbook

Healthcare boards must be involved in the digital transformation of their organizations. The quality, safety, and efficiency of care is increasingly being determined by how well an organization’s technology works. This collection of case studies showcases how leading organizations have advanced on their journey towards integrating digital health solutions into their care delivery models.


Lakewood Health System’s Journey towards a Strategic, Engaged Board through Education

Effective board meetings and ongoing board education are two fundamental pieces to put in place to build a high-performing board. Recruiting for specific skills and competencies are important, but as Lakewood Health System in Minnesota has found through its governance improvement journey, ongoing board education, coupled with a recognition that staying strategic is a continuous effort, has allowed them to go from basic to highly effective governance. This case study explains how continuous board education has benefited Lakewood Health System in several ways.


Restructuring Governance for the New Healthcare Environment: The Evolution of System Governance and Development of Best Practices

America’s health systems are transforming themselves from “holding companies” of individual hospitals largely functioning independently of each other to more integrated models of care. This case study explains why systems should aim to work together in a streamlined and cohesive manner in order to reduce or eliminate duplication of services, streamline layers of operations, and standardize care processes and procedures to improve quality and lower costs.


Top-Performing Hospitals in Patient Experience: Governance and Leadership

These case studies feature three top-performing organizations using NRC Health’s Real-time feedback surveys. Each case describes the critical factors that have led to this success and highlights the key roles of the board and C-suite in achieving it. For more information on the board’s role and best practices in improving patient experience, please see the companion white paper that features these case studies, Patient Experience Is Quality: The Role of Healthcare Leaders in Improving Outcomes and Building Loyalty


Reimagining Hospital Facility to Meet Patient Needs, Today and Tomorrow

Many U.S. hospitals are experiencing duplication of services resulting from consolidation and decreasing inpatient volume. Carolinas HealthCare System Blue Ridge faced this problem in 2013 due to its Valdese hospital being only eight miles from its larger Morganton hospital. This case study profiles the story of Valdese and how the Carolinas HealthCare System Blue Ridge board and leadership thought creatively to come up with a win-win solution.


Methodist Fremont Health: A New Partnership from a Position of Strength

Fremont Health was a small, independent health system based in Fremont, Nebraska. Financial threats caused them to explore a partnership and in 2018, they partnered with Nebraska Methodist Health System and became Methodist Fremont Health. This case study explores the reasons behind their partnership as well as their new board structure and benefits of the merger.


Main Line Health Builds a More Diverse System Board

Main Line Health, serving portions of Philadelphia and its western suburbs, spent a decade of intense effort to make their board more diverse and reflective of the communities they serve. This case study explains how this shift in the demographic make-up of the board has resulted in meaningful change in how the board operates and generated significant benefits for the organization.


Revamping Strategic Planning at Summit Health

Summit Health is a non-profit healthcare system located in south-central Pennsylvania. This case study is focused on Summit Health's high performance in strategic planning based on its Governance Institute BoardCompass® Board Self-Assessment scores. The organization performs far above the national average for three important recommended practices. The health system realized it needed to make strategy more measurable, clear, and meaningful to staff throughout the organization— from leadership to the front lines.


Building a Better Health System through Board Education and Communication

Premier Health oversees four major hospitals and dozens of additional healthcare facilities in southwest Ohio. This case study explores Premier Health's decision to create a unified system identity and structure through reorganization from a joint operating company model to a joint venture model (with parent/member ownership focused at the top-most vs. hospital level). This transition transformed the roles and effectiveness of the system and local boards, and allowed the system to be more integrated, nimble, and cost-effective in order to improve performance more quickly.


Taking Governance to the Next Level: Driving Improvements through the Board Self-Assessment

Today’s hospital and health system boards are facing a multitude of obstacles. To ensure they are effectively governing and reaching their highest potential, it’s critical that boards take time to perform a yearly formal assessment, and use the results to make sustainable improvements to governance. This case study highlights three healthcare organizations that have shown strong improvements in their scores year over year—Centra Health, Schneck Medical Center, and Logan Regional Hospital.


Elevating Patient Experience: Lessons Learned from High-Performing Organizations

The Picker Institute, part of NRC Health (The Governance Institute’s parent company), is at the forefront of patient-centered care and uses the HCAHPS and CG-CAHPS  results to determine high performers in the United States and Canada. This case study shares some examples of best practices based on the Picker Institute’s findings, and explores steps the board can take to strategically plan for improvements in patient experience.


Accountable Care Organizations: Past, Present, and Future

View the accompanying white paper

These case studies were conducted as research for The Governance Institute’s Spring 2018 white paper, Accountable Care Organizations: Past, Present, and Future. They follow three organizations, Memorial Healthcare System (Medicaid ACO), covering Broward County and surrounding areas in South Florida, Hackensack Meridian Health (Hackensack Alliance Medicare ACO), in New Jersey, and Baystate Health and Baycare® (Commercial ACO), located in Springfield, Massachusetts.

Authors: Joseph F. Damore, FACHE,   Seth Edwards, M.H.A.,   Guy M. Masters, M.P.A.


Living the Mission at ProMedica: Innovative Approaches to Improving Community Health

Case Study Brief

ProMedica serves 27 counties in northwest Ohio and southeast Michigan. 10 years ago, evidence became increasingly clear that the community was struggling to achieve improved health outcomes for its citizens. With this in mind, ProMedica began to evaluate new and non-traditional approaches focused on the social determinants of health to enhance care and improve health and well-being not only for individuals, but for the community as well.


One Jefferson: Accelerating Reinvention of Academic Medicine through Growth, Integration, and Innovation

By 2012, Thomas Jefferson University Hospital faced questions about its future both as an academic medical center and as a stand-alone large hospital in Philadelphia. This case study examines the pluses and pitfalls of rapid transformation of a university-hospital complex at a time when many face potential “extinction.”


Improving Community Health: Case Studies

View the accompanying white paper

These case studies were conducted as research for The Governance Institute’s Fall 2016 white paper, Improving Community Health: Leading Governance Practices to Catalyze Change. They follow three organizations, Dignity Health, headquartered in San Francisco, California, Providence Health & Services, based out of Renton, Washington, and Boston Children’s Hospital.


Leadership, Governance, and Changing the Business Model at Carilion Clinic

This case study focuses on the transformation of Carilion Clinic, a $1.5 billion physician organization that includes hospitals, clinics, and a college of health sciences, along with a cutting-edge medical school and research institute in partnership with Virginia Tech. It covers the catalysts for change, local market issues affecting the decisions, designing the clinic model, creating an attractive work environment, and fulfilling the clinic’s mission to create healthier communities.


Designing Governance for the Future: The New St. Luke’s Health System

St. Luke’s Health System, based in Boise, Idaho, came together over several decades through formerly independent hospitals (ranging from community medical centers to critical access and public hospitals) and physician groups, across the southern region of the state, forming various types of affiliations and arrangements until ultimately becoming one organization. This case study focuses on why St. Luke’s saw a need to restructure governance and operations, the key decisions surrounding the restructure, the process for implementation, and results to date.


Hospital Foundation Boards Rely on Skills and Training to Boost Impact

Just like the governing board, the foundation board functions best when it selects board members based on needed skills, receives appropriate training for its role, and conducts regular self-assessments to maintain and improve its work. In this case study we will look at changing patterns in healthcare fundraising, and will examine some of the methods foundation boards use to increases their effectiveness. This case study profiles ProMedica Health System in Toledo, Ohio and Anne Arundel Medical Center in Annapolis, Maryland.

Author: Elaine Zablocki


Rural Providers Band Together

In light of recent changes in payment methodologies, some rural hospitals are joining together to participate in Medicare’s Shared Savings ACO Program. Through these innovative alliances, they hope to gain knowledge, skills, and experience that will prepare them for population health management and value-based purchasing. This case study profiles Morris Hospital in Morris, Illinois, Ridgecrest Regional Hospital in Ridgecrest, California, and Reid Health in Richmond, Indiana.

Author: Elaine Zablocki


Salem Health Models Widespread Quality Improvement

Salem Health is a not-for-profit regional medical center located in Salem, Oregon. This case study explains how Salem Health has evolved its own models for quality improvement without the help of a corporate quality improvement office. Its experience shows that consistent, open-minded effort yields significant results and could serve as an important example for other community-based hospitals with a strong commitment to quality.

Author: Elaine Zablocki

Quality Improvement Project Charts:


Loma Linda University Health Reaches Out to Share Its Vision    |    ePub

Loma Linda University Health includes a 371-bed medical center, five additional hospitals, and eight health-related professional schools. This case study shares the work Loma Linda is doing, including integrating the university, hospitals, and physician organizations into one organizational structure; encouraging employees to improve their health through its corporate wellness program; and starting Vision 2020, a fundraising campaign to prepare the organization for success in coming decades.

Author: Elaine Zablocki


Health First Prepares for the Future Healthcare Business Model (Part 2)    |    ePub

During the past two-and-a-half years, Health First has experienced many major changes. Four independent hospitals started to act like a unified organization and physicians started to receive scorecards on their quality and safety, cost-effectiveness, and patient satisfaction. In this case study, we examine some of the factors that make Health First a leader in preparing for our future system of healthcare.

Author: Elaine Zablocki


Health First Prepares for the Future Healthcare Business Model (Part 1)   |    ePub

During the past two-and-a-half years, Health First has experienced many major changes. Four independent hospitals started to act like a unified organization and physicians started to receive scorecards on their quality and safety, cost-effectiveness, and patient satisfaction. In this case study, we examine some of the factors that make Health First a leader in preparing for our future system of healthcare.

Author: Elaine Zablocki


Building a Culture of Accountability from Within: The Transformation of Scripps Health   |    ePub

When Chris Van Gorder first arrived as COO, Scripps Health was facing a number of challenges. The crisis became clear when, just six months later, the medical staffs of each of the six hospital campuses in the system voted no confidence in the CEO. The board asked Van Gorder to step in as interim CEO and within a month he became the clear choice as Scripps Health’s permanent leader. Since then, Scripps Health has seen drastic improvements in financial performance, turnover rates, and employee morale.


Wellmont: Rural Health System Prepares for Challenging Future   |    ePub

Rural hospitals and health systems face unique challenges. This case study shares how Wellmont Health System, a rural system in Kingsport, TN, is dealing with these very challenges, among others, and has created proactive responses to prepare for a challenging future.

Author: Elaine Zablocki


Genesys Health System Tackles Pioneer ACO Challenge (Part 2)   |    ePub

Pioneer ACOs are organizations that already have experience offering coordinated, patient-centered care, and already operate in ACO-like arrangements. In 2011, Genesys Health System and its physician partners applied for and were selected as one of 32 Pioneer ACOs, which are developing innovative models of population-based healthcare. In Part Two, we look more closely at the system’s relationship with its physicians, and how those special relationships prepared the way for Genesys’ current role as a Pioneer ACO.

Author: Elaine Zablocki


Genesys Board Transitions to a New Level to Prepare for Healthcare Change (Part 1)   |    ePub

Leaders at Genesys Health System took steps over a six-year period to ensure that all aspects of system leadership were working at a very high level. The organization prepared itself in order to ensure its success through this incredible time of transition. Part One focuses primarily on new structures and processes the Genesys board has implemented within a remarkably short timeframe to prepare for changes in the healthcare delivery and payment system.

Author: Elaine Zablocki


Quality Reporting Expands beyond Hospital Walls   |    ePub

These days, many hospitals and health systems are offering their patients increasing information about the quality of care they can expect when they enter the hospital. However, the BayCare quality report card is an outstanding example of detailed information. This case study provides a detailed review of BayCare’s hospital-based quality report card, and then explores the organization’s efforts to expand quality reporting beyond hospital walls, across the care continuum.

Author: Elaine Zablocki


Bringing Hospitals Together to Provide High-Quality Care   |    ePub

Hospital consolidation is on the rise as organizations work to prepare for the changes and challenges of health reform. This case study profiles two organizations: one that recently entered into a partnership and another that has acquired several hospitals throughout the years. It provides insight into the benefits of partnering and what goes into finding the right partner. 


Patient Experience: Best Practices for Service Excellence   |    ePub

This case study profiles the experiences of three member organizations that have decided to focus on patient satisfaction as a key strategic priority. Each organization has changed their culture to address the patient experience and, through this process, seen significant improvement in their HCAHPS survey scores.