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IN THIS SUMMARY In Partnership of Equals, Peter McGinn discusses the various ways in which CEOs and board members can productively work together to resolve conflict and make a better, more effective healthcare organization. The CEO advises the board and has a position of influence rather than authority. There are many situations where the board has the ultimate say, but that does not mean that CEOs should hold back their opinions until they are asked. They are there for a reason, and that is to share their thoughts and experiences. The board should appreciate input from the CEO, but they should not allow the CEO to make decisions or accomplish activities that are the board’s responsibility.
PARTNERSHIP OF EQUALS Practical Strategies for Healthcare CEOs and Their Boards AUTHORS: Peter McGinn PUBLISHER: Health Administration Press DATE OF PUBLICATION: 2009 155 pages
FEATURES OF THE BOOK Partnership of Equals is helpful for CEOs and board members working within healthcare organizations.
THE BIG IDEA In Partnership of Equals , Peter McGinn discusses the various ways in which CEOs and board members can productively work together to resolve conflict and make a better, more effective healthcare organization.
INTRODUCTION Successful healthcare organizations require constant collaboration between healthcare CEOs and the organization’s board of directors. In Partnership of Equals , Peter McGinn discusses the various ways in which CEOs and board members can productively work together to resolve conflict and make a better, more effective healthcare organization.
SELECTING THE BOARD The CEO advises the board and has a position of influence rather than actual authority. There are many situations where the board has the ultimate say, but that does not mean that CEOs should hold back their opinions or judgments until they are asked. They are there for a reason, and that reason is to share their thoughts and experiences. CEOs should be proactive when helping the board select new board members . The CEO has an immense interest in making sure that the right people are on the board; doing so ensures that the board and CEO will be able to work together smoothly in the future and that there will be a diversity of experience and knowledge within the board itself.
WHEN PHYSICIANS ARE ON THE BOARD Having physicians on the board of directors serves as an excellent reality-check tool for the organization. Physicians know about the technical and patient-related aspects of the healthcare industry, and bring their in-the-field experience and insight to the table. CEOs must be careful, however, not to assume that the opinion of the physician on the board represents the opinion of the entire medical staff.
WHEN PHYSICIANS ARE ON THE BOARD The CEO should have scheduled meetings with a wide array of medical staff members to keep up to date on the staff’s needs and concerns . They should also identify potential board members within the physician staff. When they identify individuals with board potential, they should put them in positions of leadership to see how they perform. Once a physician is welcomed into the board, the CEO should continue to coach and encourage them, providing them with educational opportunities to enrich their understanding of board, management, and organizational healthcare topics.
THE CHAIR, THE EXECUTIVE COMMITTEE, AND SUCCESSION PLANNING The CEO should provide support and encouragement for the board chair . The CEO and the board chair’s interactions and values set an example for the entire board. Because of this, it is very important that the two maintain a trusting and respectful relationship. They should also be sure to groom up-and-coming leaders within the board for both the board chair position and the executive committee, so that they do not have to settle for less-than-ideal candidates when board leadership positions become vacant.
THE CHAIR, THE EXECUTIVE COMMITTEE, AND SUCCESSION PLANNING The executive committee should be continually mentoring and coaching board members who show particular leadership potential . Once an individual has made it to the executive committee, the coaching and mentoring should not end, but should continue on a regular basis. Boards should also make sure to be forgiving of mistakes and open to new ideas. Demanding perfection only serves to belittle ideas that are different and discourage innovation within the board.
THE CHAIR, THE EXECUTIVE COMMITTEE, AND SUCCESSION PLANNING Traditionally, planning for the succession of the CEO is the board’s job, but it is a good idea for the CEO to bring the subject up for discussion. They will not be able to select their own successor, but the CEO will be able to give honest and effective insight into the talents and qualities that their successor will need to possess in order to do their job successfully.
DEFINING DIRECTION AND ESTABLISHING STANDARDS Part of defining direction is defining values . CEOs can encourage solid and reliable values by publicly holding themselves and others accountable to the values established by the organization. The CEO and the board should also work together to come up with a strategic plan for the organization that unites its values, mission, vision, environmental assessments, and competitive business case.
DEFINING DIRECTION AND ESTABLISHING STANDARDS The CEO should also include management’s opinions in this discussion. As the purpose for the organization is defined, board members should make sure that their loyalty to the CEO or to staff does not come before their obligation to the community. To do so, the board should share their understanding of the values of the community to help the CEO craft values that accurately reflect those of the surrounding populace.
APPRAISAL AND DEVELOPMENT <ul><li>CEOs should be proactive about their performance appraisals and coordinate their appraisals with the annual planning process of their organization. In this way, the board and the CEO will be able to identify how the organization’s and CEO’s objectives match up. </li></ul><ul><li>During the appraisal, both parties should do the following: </li></ul><ul><li>Note the areas in which the CEO’s personal involvement is essential. </li></ul><ul><li>Identify where qualitative assessment tools should take precedence over quantitative tools. </li></ul><ul><li>Outline how they will measure success. </li></ul><ul><li>Establish the ways in which they will assess the organization’s long-term goals and annual objectives. </li></ul>
MANAGING PROBLEMS CEOs should expect problems and have systems in place to unearth, fix, and track them. They should encourage the board to create processes for identifying and addressing conflicts of interest. It is not the CEO’s job to create these processes, but they should give their honest opinions when the board is developing them. The CEO needs to create tracking mechanisms to ensure that the solutions to the problems are permanent and not just temporary fixes.
MANAGING PROBLEMS This is of particular importance in regards to the personal performance changes that an individual may need to make; quite often a person will behave appropriately for a short amount of time and then revert back to their old behaviors. Lastly, the CEO should keep the board abreast of any significant problems the organization has, but they should not ask the board to take action until it is necessary. They should make sure to be clear with the board about the difference between a report and a request for help.
RELATIONSHIP BUILDING & BOARD MEETINGS CEOs should model the behaviors that they want to see in their board members . They should also foster and encourage positive relationships between themselves, the board, and between board members. The board and CEO cannot get work done in an effective manner without a certain level of trust and respect.
RELATIONSHIP BUILDING & BOARD MEETINGS This friendship does not mean that individuals should withhold from disagreeing with one another so as not to hurt each other’s feelings. On the contrary, they should have enough respect for one another’s opinions that they feel comfortable openly and politely disagreeing. The CEO should also explain the rationale behind their decisions to help gain the board’s trust and understanding.
MAXIMIZING PARTICIPATION IN BOARD MEETINGS AND MAKING DECISIONS CEOs should utilize the differences between board members to spur discussion and get varying views on a single subject. They should also avoid making healthcare seem too large or complex, as they might intimidate some board members from participating and openly contributing their valuable insights. Board members can also educate themselves about the healthcare system in order to avoid becoming daunted by complex healthcare jargon.
MAXIMIZING PARTICIPATION IN BOARD MEETINGS AND MAKING DECISIONS The CEO should model the discussion skills they want the board to utilize , such as pertinent listening and building on the ideas and suggestions of others. Older members of the board should reach out to newer members and guide them into contributing their perspectives. They should also use questions to further the topic of discussion, which is often much more productive for the conversation than making a straightforward statement or assertion.
SUBSIDIARY AND SYSTEM BOARDS In today’s complex healthcare environment there usually exist two types of boards, the subsidiary board and the system board. Subsidiary refers to the many different organizations and companies that are owned by a large, overarching organization, known as the system. Each subsidiary owned by the system might have its own board; there could be many different subsidiary boards, while there is only one system and one system board.
SUBSIDIARY AND SYSTEM BOARDS The system CEO must make sure that their system board knows where their responsibilities lie and where those of the subsidiaries’ boards lie . The CEO will have to coordinate synergy between the system and its subsidiaries and in doing so they will have to be cautious not to jump to conclusions or assume that the system is always right. Additionally, they will need to focus a large amount of time on defining roles, developing shared values, and planning with and between the various subsidiaries.
SUBSIDIARY AND SYSTEM BOARDS The board should insist on maintaining an open dialogue in order to ensure that they make decisions that are in favor of both the system and its subsidiaries. They should also make sure that the CEO explains the architecture of the system, the standards for communication with the various subsidiaries, and the authority matrix.
SUBSIDIARY AND SYSTEM BOARDS Doing so will ensure that effective interactions take place between the system and the subsidiaries, and that issues are handled in the appropriate manner, department, and amount of time. Lastly, the board should help the CEO achieve an effective level of integration between the subsidiaries and the system.
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