Center for Healthcare Governance

Center Monographs

Members of the Center for Healthcare Governance receive four monographs per year, on topics of current interest to governing boards. The monographs provide in-depth discussion on emerging issues and trends, and discuss how leading organizations are addressing them. Previous topics have included board compensation, board policy and practice improvement, and the board’s role in the quality imperative.
PURCHASING:  Center monographs are available for individual purchase at $20 each.  Please contact us to purchase archived monographs. Phone: 888-540-6111 | Email: info@americangovernance.com
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Titles include:
  1. 2012– Organizational Culture, Clinician Engagement and Physician Integration: Keys to Success
    Authors William F. Jessee, MD and David Rowlee, Ph. D. from Integrated Healthcare Strategies, discuss the evolution of hospital/physician relationships from alignment to engagement and integration as a critical path for the improved performance necessary to achieve greater value. They focus on the important role of culture as a driver of greater engagement and suggest that the board’s role will encompass ensuring that robust systems are in place to measure, analyze and improve performance, including the areas of culture and engagement.
    This monograph includes examples of instruments that measure culture in health care organizations and medical groups. It discusses key factors that influence physician engagement with hospitals and the types of improved performance that stronger engagement fosters. The authors also discuss nine steps that organizations and their governing boards can take to improve performance:
    • Assess organizational culture
    • Measure engagement of employees, physicians and volunteers
    • Deploy clinical integration tools
    • Recruit physicians and employees for cultural fit
    • Actively manage culture conflicts
    • Set clear behavior and performance expectations
    • Provide regular feedback on individual and organizational performance
    • Don’t tolerate cultural misfits or poor performers
    • Align compensation with performance measures
    About the Authors:
    William F. Jessee, MD, FACMPE, is a Senior Vice President and Senior Advisor and David D. Rowlee, Ph.D., is Senior Vice President of the Engagement Opinion Survey service line with Integrated Healthcare Strategies, which provides consultative services and people-based solutions to clients across the health care spectrum, including community and children’s hospitals, academic medical centers, health networks, clinics, and assisted-care providers.
    To purchase the monograph, click here.
  2. 2012– Transformational Governance: The Challenges Facing Trustees of Nonprofit and Public Hospitals
    Governance is an essential element of survival and success for both nonprofit and public hospitals today. It is more vital than ever to have effective governing boards that can address the traditional demands of trusteeship, while meeting the new legislative and regulatory challenges, increased competition and a rapidly changing health care environment.
    The dramatic pace of health system change in the last decade has included enactment of the most comprehensive and historic health reform legislation since Medicare and Medicaid. But many of the changes that are transforming health care, such as the need for improved care quality and patient safety and care that is accessible and affordable, were already underway before health reform was enacted.
    A dramatic transformation of the organization and structure of hospitals and health systems across the country is underway. Nothing less than transformational governance will suffice for those hospitals that hope to keep pace.
    It is not the purpose of this monograph to rewrite the traditional rules of effective governance or to supplant common wisdom about the responsibilities of hospital trustees. Rather, I have sought to build upon those rules and that wisdom to help trustees identify areas where key elements of traditional governance may benefit from additional observations in the current environment.
    About the Author:
    Larry Gage is a partner in the health care practice group of the law firm of Ropes and Gray LLP. He served from 1981 to 2011 as President of the National Association of Public Hospitals and Health Systems.
    To purchase the monograph, click here.
  3. 2012– Transforming Care Delivery to Focus on Patient Outcomes: Why Boards Matter
    Improving health care quality and safety to create better outcomes and greater value for patients and communities can be a daunting challenge for leaders trying to transform our delivery system. In fact, the challenges are so large that it makes sense for key stakeholders of the health care system to work together to accelerate change. Many Blue Cross and Blue Shield (BCBS) health plans have partnered with hospital associations and hospitals to line up training, toolkits, data reporting and financial incentives to create a new health care delivery paradigm. Small, significant steps are moving us in the right direction under the guidance of hospital leaders and clinical champions.
    The financial pressures are well documented in the popular press and annual reports of hospitals, insurance companies, government agencies and the checkbooks of the patients we serve. Annual spending on health care delivery is enormous and rising, representing $2.5 trillion that competes with many other social imperatives in our communities. Insurers, as well as hospital leaders, are alarmed by the constant upward trend in spending.
    And the question remains, is the money being well spent? One study estimates that at least 30% of every dollar actually spent on care is funding ineffective or redundant care (Institute of Medicine, 2005). A recent report indicates that 84,000 premature deaths could be prevented if the US performed as well as some other nations (The Commonwealth Fund, 2011). Care is not only expensive, but sometimes actually harms the patient. One study suggests that $17 billion a year is spent on medical errors (Classen, et al., 2011). Our current approach to paying for services focuses on the volume or the number of procedures done to a patient, rather than on a successful outcome.
    About the Author:
    Christine Izui is Executive Director Quality, Office of Clinical Affairs, at the Blue Cross and Blue Shield Association, Chicago, IL.
    To purchase the monograph, click here.
  4. 2011– The Expanding Role of the Compensation Committee

    Historically, CEO compensation often was set by the hospital board chair or a small group of board leaders, with little or no input from the rest of the board. Even as compensation committees started to perform their roles more thoroughly, the full board was not made aware of the committee’s work or results.In recent years, increased regulatory requirements, the revised Internal Revenue Service (IRS) Form 990, media attention and general public scrutiny have focused board attention on executive compensation. The Patient Protection and Affordable Care Act of 2010 (ACA), which links Medicare payments to clinical quality measures and the patient’s overall care experience, has further sharpened the focus on hospital, and therefore executive, performance. These trends and the introduction of performance-based variable pay plans have added goal-setting for and performance evaluation of the organization’s chief executive to the duties of the Compensation Committee. In this context, the role of the board’s Compensation Committee has expanded, in scope and importance, beyond setting top executive salaries. The committee has become responsible for clarifying a health care organization’s strategic goals and aligning their accomplishment with compensation.
    Today, the committee’s role continues to expand, as it is being called upon to oversee succession planning and senior executive bench strength development. It now performs virtually all important human resource functions related to the organization’s top executives.
    Having the right people in place, seeing to their development and aligning their compensation with strategic goals are central to mission success. Ensuring that the organization advances strategically requires not only effective compensation programs, goal setting and performance evaluation, but also the development of a pipeline of key talent to provide bench strength and mitigate disruptive transitions.
    Thus, the Compensation Committee has become the center of three critical board responsibilities: executive compensation, goal-setting and performance evaluation, and succession planning. This monograph discusses each of these functions, describes related best practices and provides examples and tools to help tax-exempt hospital boards effectively fulfill these important responsibilities.

    About the Authors:
    Rian M. Yaffe     is CEO and chairman and Alexander C. Yaffe is president of Yaffe & Company, which provides non-profit boards and Compensation Committees with independent advice regarding regulatory compliance, governance and other critical board responsibilities, including: executive compensation and contracts, goal-setting and performance evaluation, succession planning, leadership development and CEO transition. Yaffe & Company combines the technical knowledge and expertise of its career consultants with the management and governance experience of the former hospital/health system CEOs it employs.

    This item is currently out of stock

     

  5. 2011– Journey to High Value Healthcare: The Board’s Role in Clinical Transformation

    As American health care delivery transitions to a value-based model, transformation leadership will be needed within each organization to create the health system of the future.
    In Journey to High Value Healthcare: The Board’s Role in Clinical Transformation, author Pam Arlotto, President and CEO of Center affiliate member Maestro Strategies, provides a guide for boards and the health care C-Suite as they align strategies, decision-making tools, processes, information technology and people to build new organizational capacity for clinical transformation.
    This publication defines the role of the board in overseeing this transition and explores the concept of an Information Technology (IT) Committee of the board. It also discusses meaningful use of electronic health records as part of the necessary foundation for accountability.
    The author provides a snapshot of where the health care industry is today in implementing meaningful use of information technology. She also discusses eight strategies to help boards develop a clear plan and evaluate progress toward accountablemeaningful use. Assessment questions are included to help boards critically examine their own institution’s progress.
    This publication can be used as the basis of a board education session or strategic planning retreat that focuses on implementing IT and using health information to drive delivery of more accountable, value-based care. Boards can also use this publication to guide discussion of how they can best oversee information technology resource allocation and implementation.

    About the Author:
    Pam Arlotto     is President & CEO of Maestro Strategies, LLC., a healthcare management consulting firm that assists boards, CEOs and the C-Suite as they navigate the challenges of clinical transformation. Ms. Arlotto can be reached at parlotto@maestrostrategies.com.

     

  6. 2011– Transparency: How Much of a Good Thing?

    Move over, “paradigm.” Step aside, “synergy.” Make way for “Transparency”—today’s clarion call in health care.     

    From all corners of society—from government to corporate America to the media to health care—transparency has become a drumbeat for greater openness, candor and transparency.However, transparency, as you’ll see, is much more than disclosing the cost of treating pneumonia.

    Based on two decades of consulting with more than 100 hospitals and health care systems, and countless conversations with hospital executives, trustees and medical staff leaders, we propose to explore transparency along these six venues:

    1. How best to define transparency?
    2. Who are its constituents?
    3. How is it viewed by health care leaders?
    4. What is the law of the land?
    5. What are the benefits?
    6. What are the risks?

    And throughout this publication, and in examining a case study that could play out at your institution, we put this—the core—question on the table:

    If transparency is a good thing, then can there be too much of a good thing?

    About the Authors:
    Steve Rivkin     is managing partner at Rivkin & Associates LLC, a communications and marketing consultancy which has handled assignments for more than 100 hospitals and systems (www.HospitalCrisis.net). Mr. Rivkin can be reached at steve@rivkin.net.

    Fraser Seitel is a senior partner at Rivkin & Associates LLC. Mr. Seitel can be reached at fraser@rivkin.net.

     

  7. 2011– Competency-Based Governance Tool Kit

    In 2009 the Blue Ribbon Panel on Trustee Core Competencies, convened by the AHA’s Center for Healthcare Governance and the Health Research & Educational Trust with funding from Hospira, issued its report recommending two sets of core competencies for board members of hospitals and health systems. The panel also suggested that tools and resources should be developed to help boards apply these competencies to a variety of board practices.

    Over the past year a work group of health care organization trustees, executives and governance experts developed four sets of competency-based tools that boards can use in trustee recruitment and selection, board member education and development, peer assessment of individual board member performance and board leadership development and succession planning. The tool sets were tested by hospital and system boards and finalized for distribution to the field.

    The Competency-Based Governance Tool Kit includes all of the tool sets and step-by-step processes for implementing each of them. The Tool Kit also provides an overview of how the tools were developed and a model that shows how application of the tools can help boards establish a competency-based foundation for governance effectiveness.

    Price:
    – Order a copy of this tool kit for $59
    – Order a copy of this tool kit + the 2011 Monograph: Competency-Based Governance Enters the Health Care
    Boardroom     for $70

    To view the preface of the tool kit, click here.

  8. 2011– Competency-Based Governance Enters the Health Care BoardroomAbout the Authors
    Deborah J. Cornwall

    is Managing Director of The Corlund Group LLC, a Boston-based consulting firm focused on assisting organizations with executive leadership assessment and development, governance effectiveness, and change management. Ms. Cornwall can be reached at dcornwall@corlundgroup.com.Mary K.Totten is Director of Content and can be reached at megacom1@aol.com.

    To view the preface of the monograph, click here.

  9. 2010– Health Care Reform and the Trustee’s Role 

    About the Author
    John R. Combes, M.D. is President and Chief Operating Officer of the American Hospital Association’s Center for Healthcare Governance. He can be reached at jcombes@aha.org.To view the preface of the monograph, click here.

  10. 2010– The New Age of Accountability: Board Education and Certification, Peer Review, Director Credentialing and QualityAbout the Author:

    Sean Patrick Murphy is Senior Vice President, Corporate General Counsel for Solaris Health System, Edison, New Jersey. Mr. Murphy is a Senior Fellow at the Jefferson University School of Population Health, Philadelphia, Pennsylvania. He lectures and writes extensively in health care and health law, and governance. He received his A.B. with Honors from Rutgers College, his Masters Degree in Health Services administration from George Washington University and his J.D. from Rutgers University School of Law, Newark. He is a member of the New Jersey and Pennsylvania Bars.Anne D. Mullaney is a partner at Pittsburgh’s Thorp Reed & Armstrong and Chair of the firm’s Health Law Practice Group. She received her laws J.D. from Duquesne University, Pittsburgh, Pennsylvania and her Masters Degree in Health Services Administration (MHA) from the George Washington University, Washington, DC.

    To view the preface of the monograph, click here.

  11. 2009– Strategic Resource Allocation: The Board’s Critical RoleAbout the Author:

    Susanna E. Krentz is President of Krentz Consulting; Cathy Sullivan Clark and Scott B. Clay are Senior Principals and Dennis V. Kennedy is a Principal at Noblis Health Innovation, which offers advisory services, applied research and innovative solutions for health care providers and the broader health care community.To view the preface of the monograph, click here.

  12. 2009– Successful Strategic Planning: The Board’s RoleAbout the Author:

    Gene J. O’Dell is Vice President, Strategic & Business Planning for the American Hospital Association and Vice President, Development & Operations for the Center for Healthcare Governance. John R. Combes, M.D. is President and Chief Operations Officer of the Center for Healthcare Governance.This monograph was adapted from a chapter they originally wrote for Governance for Healthcare Providers, published by Productivity Press.To view the preface of the monograph, click here.

  13. 2009– Managing Capital Project Risks in a Challenging Environment: What Health Care Boards and Executives Need to KnowAbout the Author:
    Fred Campobasso

     is the Managing Director for Navigant Consulting Inc.’s Healthcare Real Estate practice. Joe Kucharz and Mike O’Keefe are both Directors with Navigant Consulting. Navigant Consulting provides comprehensive Facilities and Real Estate Solutions to healthcare organizations around the country. Services include strategic and operational planning, program/project management, real estate advisory, development, and capital services. The authors would like to acknowledge and thank Catherine Anderson, Dave Brown and Jim Klima from Navigant Consulting’s Healthcare Real Estate practice who provided industry knowledge and insight into this publication.

    To view the preface of the monograph, click here.     

  14. 2008– Healthy Board/Medical Staff Relationships: Current Trends & PracticesAbout the Author:
    Jay Justice, JD,

     is Vice President and Senior Human Resources Officer, Hospital Sisters Health System in Springfield, IL; A. Kurt Kastel is a Senior Consultant with Integrated Healthcare Strategies and Kevin Van Dyke, MPP, is a Research Manager at the Health Research & Educational Trust.To view the preface of the monograph, click here.

     

  15. 2008– Putting Quality First: How Boards Can Make Quality Improvement a Higher PriorityAbout the Author:
    David A. Bjork, Ph.D.

     is Senior Vice President and Senior Advisor of the Executive Total Compensation practice at Integrated Healthcare Strategies, a consulting firm that specializes in executive compensation, executive search, physician services, human resource capital and governance and leadership services for healthcare organizations.To view the preface of the monograph, click here.

     

  16. 2008– Best Practices for Developing Effective and Enduring Board/CEO RelationshipsAbout the Author:
    Kenneth R. Cohen, Ph.D.,

     is president of The Synergy Organization, a national metrics and evidence-based health care executive search/leadership assessment firm he established in 1988. Dr. Cohen is an organizational psychologist, executive search consultant and leadership researcher. He is a frequent consultant, speaker and author on the application of best practices in governance, leadership, recruitment, selection and retention strategies.To view the preface of the monograph, click here.

     

  17. 2008– Pay-for-Performance: A Guide for Hospital TrusteesAbout the Author:
    Sanjaya

     Kumar, MD, M.Sc., MPH, is President, CMO and Chairman of the Board of Quantros, Inc, a Milpitas, CA-based company that provides real-time knowledge solutions for benchmarking, patient safety, accreditation and compliance and outcomes monitoring for health care providers, payers and pharmaceutical companies.To view the preface of the monograph, click here.


  18. 2007– Leadership Continuity: Avoiding the Ultimate “Gotcha”About the Authors:
    Deborah J. Cornwall

     is Managing Director and Wilmot J. Gravenslund is Director of The Corlund Group LLC, a Boston-based consulting firm focused on assisting organizations with executive leadership assessment, transitions, and development; governance effectiveness; and change management.To view the preface of the monograph, click here.



  19. 2007– A Seat at the Power Table: The Physician’s Role on the Hospital BoardAbout the Authors:
    Jayne Oliva

     is principal with the Croes Oliva Group, a team of medical group management diagnosticians which works with health care organizations and their affiliated physicians, as well as private practices, to improve front-line operations and boost performance in profitability, productivity, patient access, and patient care coordination. She also coaches and mentors physicians for optimum leadership performance. Jayne holds an MBA from the Kellogg Graduate School of Management at Northwestern University. She teaches graduate level courses in outpatient care delivery and physician practice management, speaks nationally and appears frequently in regional and national publications.Mary Totten, Director of Content, is a speaker and consultant to hospitals and health systems, and other health-related organizations on quality of care and medical staff credentialing, strategic planning and mission development, governing board orientation and board self-evaluation and governance restructuring. She conducts board retreats and education programs and writes and publishes books, articles, and newsletters for health care leaders, including the American Hospital Association’s The Guide to Governance for Hospital and Health System Trustees, first and second editions; The Board’s Role in Quality of Care:A Practical Guide for Hospital Trustees, The Future of Health Care Governance: Redesigning Boards for a New Era and The Trustee Handbook for Health Care Governance, first and second editions. Mary holds a MBA from the Kellogg Graduate School of Management at Northwestern University.

    To view the preface of the monograph, click here.


     

  20. 2007– Hospital-Physician Clinical IntegrationAbout the Authors:
    John H. (Hank) Duffy

     is the founder and president of the JHD Group, an Addison, TX-based consulting firm that assists large physician organizations to improve market position, operations and financial results. Trent Green is a director with Navigant Consulting.To view the preface of the monograph, click here.



  21. 2006– Are You Rolling the Dice on CEO Succession?About the Authors:
    Deborah J. Cornwall is Managing Director and Wilmot J. Gravenslund is Director of The Corlund Group LLC, a Boston-based consulting firm focused on assisting organizations with executive leadership assessment and development, governance effectiveness and change management.

    To view the preface of the monograph, click here.

     

  22. 2006– The Board’s Fiduciary Role: Legal Responsibilities of Health Care Governing BoardsAbout the Authors:
    Fredric J. Entin and Janice A. Anderson are partners in the Health Care Industry team and Katherine S. O’Brien is an associate and member of the Health Care and Energy Industry teams and the Business Reorganizations practice at the law firm of Foley & Lardner LLP. The firm has offices across the United States and more than 60 practice areas encompassing a full range of corporate legal services, including corporate governance, securities enforcement, litigation, mergers and acquisitions, intellectual property counseling and litigation, outsourcing and information technology, labor and employment, and tax.

    To view the preface of the monograph, click here.

     

  23. 2006- Becoming an Employer of Choice: A Key Strategy for Success 

    Winner of the Malcolm Baldrige National Quality Award. Recognized nationally for several years as one of the “100 Best Companies to Work For” by both Working Mother and Fortune magazines. Today, Center member Bronson Healthcare Group in Kalamazoo, Michigan is known as one of the “best of the best” organizations in America; however, ten short years ago, things were very different.This monograph tells the story of a health care organization that a decade ago was facing an uncertain future. Bronson realized that it had to confront and address several “brutal facts” in order to get moving in the right direction. Thanks to a committed governing board, stellar leadership, determined employees and physicians, and a vision of excellence, Bronson transformed itself into the first-class organization it is today largely by focusing on becoming an Employer of Choice as a key strategic initiative..

    To view the preface of the monograph, click here.

  24. 2006– Creating a Culture of Collaborative Leadership Between Boards and CEOs: A Practical Guide for Trustees 

    About the Authors:
    David A. Bjork, Ph.D., is Managing Director, and Dan Fairley, J.D., is Senior Vice President, with Clark Consulting Healthcare Group, a firm that helps health care organizations build better relationships with their executives, physicians, trustees, and employees. Services include compensation planning for executives, physicians, and employees; management succession and leadership transition planning; laborrelations; employee surveys; recruiting; and human resource management.    To view the preface of the monograph, click here.

     

  25. 2005 – Exploring Hospital-Physician Business Relationships: What Trustees Need to KnowAbout the Author:


    John H. (Hank) Duffy  is President of JHD Group. Founded in 1988 and based in Addison, TX, the JHD Group is an organization dedicated to helping large physician organizations improve market position, operations and financial results.    To view the preface of the monograph, click here.

  26. 2005 – Hospital Patient Safety and Quality Monitoring: A Resource for Governing Boards and TrusteesAbout the Authors:


    Sanjaya Kumar, MD, M.Sc., MPH is President & CMO and Chairman of the Board and Catherine Carson-Martin, RN, BSN, MPA is Director, Programs Management, at Quantros, Inc., a Miloitas, CA-based company that provides real-time knowledge solutions for benchmarking, patient safety, accreditation and compliance, and outcomes monitoring for health care providers, payers and pharmaceutical companies.    To view the preface of the monograph, click here.

  27. 2005 – Patient Safety and Quality Reporting for Governance: Data Reporting Guide for Hospital StaffAbout the Authors:


    Sanjaya Kumar, MD, M.Sc., MPH  is President & CMO and Chairman of the Board and Catherine Carson-Martin, RN, BSN, MPA is Director, Programs Management, at Quantros, Inc., a Miloitas, CA-based company that provides real-time knowledge solutions for benchmarking, patient safety, accreditation and compliance, and outcomes monitoring for health care providers, payers and pharmaceutical companies.    To view the preface of the monograph, click here.

     

  28. 2005 – Does Excellent Health Care Governance Lead to Excellent Performance? (Or, can a Great Board make a Difference?)About the Authors:
    Douglas D. Hawthorne

       is president and CEO of Texas Health Resources, the largest nonprofit health care system in the state of Texas.William L. Harrod, Ph.D.and James P. Schuessler are Principals of Signiture Healthcare Advisors, a Forth Worth and Austin, Texas-based consulting firm dedicated to improving governance in health care organizations.

    To view the preface of the monograph, click here.

View the archived American Governance Leader Monograph Series for additional past monographs.
Center monographs are $20 each. Please contact us to purchase archived monographs. Phone: 888-540-6111 | Email: info@americangovernance.com