Center for Healthcare Governance

Governance Assessment Process (GAP)

What is GAP?

The Governance Assessment Process (GAP) from the Center for Healthcare Governance is a comprehensive system used to assess the overall performance of health care organization boards.
Through a variety of detailed surveys, GAP will reveal an organization’s strengths and weaknesses, and what they must do to govern better, make a difference and add greater impact as the organization strives to fulfill its mission.
GAP is designed for boards that are serious about continuous improvement, and helps your board to thoroughly assess how well it is meeting its obligations and fulfilling its roles and responsibilities. It also evaluates the quality of the board’s structure, composition and infrastructure. Once completed, your board will be able to develop a targeted action plan for improving its performance and establish a base-line for tracking changes in performance over time. Plus, you’ll receive a candid look at where your organization ranks nationally among organizations that have undergone similar GAP assessments.
For samples of GAP Inventory and GAP Feedback please use the electronic inventory request form.

How Does the GAP Work?


Step 1:

Your board will first receive the GAP inventory either as a paper version or an online version. The 70-80 item questionnaire (depending on your board type) will take about 30 minutes for each board member to complete. The inventory is then compiled by staff at the Center for Healthcare Governance.
Step 2:
Your organization will then receive feedback through a detailed profile of your board’s performance and the extent to which it currently meets its goals, objectives and specific benchmarks for governance and leadership success. You will also receive a set of PowerPoint slides that are customized specifically for your organization, along with a comprehensive facilitator’s guide.
Step 3:
The final step in your assessment process will include a one hour telephone discussion or an onsite consultation that will explain the results in greater detail and offer advice on what you can do differently to make real improvements within your organization. This call or onsite review is typically made to the CEO and/or the chairman of the board, or can be scheduled during a board meeting or retreat in which the entire board can be addressed.
*For more information on onsite reviews please read below: Governance Assessment and Retreat.

GAP Versions

The GAP has multiple variations that can be customized according to the different centralized or decentralized areas of responsibility of your system or hospital board.
Hospital and Health System Board GAP Versions

  1. Free-standing Hospital Board
  2. Board of a System w/ no Subsidiary Hospital Boards
  3. Board of a System w/ Subsidiary Hospital Boards (Centralized)
  4. Board of a System w/ Subsidiary Hospital Boards (Decentralized)
  5. Board of a Hospital that is Part of a System (Centralized)
  6. Board of a Hospital that is Part of a System (Decentralized)
  7. System/Hospital Individual Director Self-assessment

Hospital and Health System Committee GAP Versions

  1. Audit Committee
  2. Community Benefit & Advocacy Committee
  3. Compensation Committee Executive Committee
  4. Finance Committee
  5. Governance & Nominating Committee
  6. Investment Committee
  7. Philanthropy Committee
  8. Physician Governance Council Committee
  9. Quality Committee

Please contact the Center to request a sample and for more information on how to customize your assessment(s).

Measure Your Performance Over Time

Complete the GAP program each year and you’ll be on your way to continuous improvement. We keep all of your past GAPs in a sophisticated database where we can merge past assessments and provide you with a comparative summary of the positive changes that have occurred within your organization over a specific period of time. The GAP is meant to be used as a self-facilitated workshop held during a board meeting or at a mini-retreat, where your board analyzes assessment findings and formulates plans to improve its performance.

GAP Pricing

Free (w/ membership)

Governance Assessment and Retreat

Did you know that the Center for Healthcare Governance can conduct a governance assessment and action planning retreat for your board? This package combines GAP tools with expert retreat design and facilitation services. Over one or more days, your board will focus on:

  • Executing its core governance responsibilities and roles.
  • Assessing “how” and “how well” it is governing.
  • Implementing practices employed by “excellent” boards and developing specific initiatives to achieve the highest levels of performance.
  • Improving its structure, composition and infrastructure.
  • Fulfilling its fiduciary obligations on behalf of the organization’s stakeholders.
  • Enhancing its capacity for continuous improvement.

For additional information, samples of GAP Inventory and GAP Feedback or to speak with an assessment consultant about using GAP to enhance your board’s performance and contributions, please call Joy Saris at 312-422-3245 or send an e-mail inquiry to info@americangovernance.com.