Best practices in governance effectiveness call for governing boards to conduct a self-assessment at least annually to evaluate their performance. Boards should then use the results of the self-assessment to develop a plan of action for improving their performance in specific areas.
By Karma H. Bass, MPH, FACHE, Managing Principal, and Erica M. Osborne, MPH, Principal, Via Healthcare Consulting
Board self-assessments are instruments for identifying strengths that can be leveraged to accomplish specific goals along with opportunities for improving performance in areas that are weak. These tools are intended to drive change and enhance a board member’s engagement in his or her role and with the organization. When performance is tracked from year to year, improvement can be measured.
The self-assessment alone is not enough to prompt improvement. The true value of a self-assessment is not what the results say, but what you do with those results. Once the self-assessment has been completed and results are in is when the roll-up-your-sleeves work begins.
We at ViaHCC develop individual assessment reports that provide summaries of results for specific responsibilities, mean scores, and member comments. Although too often the inclination with such reports is to “read and recycle,” we highly recommend that they be used to take action.
We have found that the best way to leverage the results of a self-assessment is to develop a plan with identified goals, a timeframe for improvement, and accountability to progress.
Key Steps for Developing an Action Plan After a Governing Board Self-Assessment
The results from the self-assessment should generate discussion aimed at improving board performance. Board members should be asking: Where are we underperforming? Do we truly understand our role in “this” specific area? Do we understand how decisions are made, and is that process robust and fair?
Boards should carve out time on their meeting agendas for holding this discussion and developing an action plan. Here are what we have found to be key steps in this process:
- Identify three to five goals.We suggest that boards focus on three to five areas of opportunity for improvement. These can be tiered into short-term, medium-term, and long-term goals. Tiering the goals will provide the opportunity for success with near-term goals, and set the momentum for progress.
- Make them SMART goals.The goals should be:
- Specific—goals that are not clear are less likely to be achieved.
- Measurable—metrics enable progress to be tracked.
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- Actionable—meaning they are achievable. The steps necessary to reach these goals must be reasonable and within the board’s control. Each goal should also have milestones for gauging progress.
- Relevant—the goals should align with the mission and specific board role.
- Timely—setting a date for reaching the goal will help members stay focused and be motivated to work toward the goal.
- Assign accountability. Although many board members may work together on one goal, one board member or a subset of the group should be ultimately responsible for driving success. If there are too many drivers, the board may never reach its destination.
- Review progress with the entire board on a regular basis. A regular review of milestones (missed or reached) will keep the goal on track and can help to reset the direction when a plan goes off course.
Always Room to Grow
A board action plan serves as a guide for improving the governing body’s performance in specific, identified areas. This might include increasing board diversity, enhancing comprehension of the governing body’s role in physician credentialing and privileging, or including more time for generative discussion, to name a few examples.
So what happens when a board rates its performance as highly effective? Is any action necessary? For these boards, we recommend adopting the mindset that governance is always a journey, never a destination. Therefore, highly effective boards are never completely satisfied with their current performance.
Consider taking a continuous improvement approach to the work and looking for areas where, while performance may be good, it could be augmented to add further value for the community, the organization, and for board members. We believe there is always room to develop governance skills and broaden perspectives.
Assessing performance can be an uncomfortable experience. No one likes to look too closely in the mirror. But attaining a genuine and thorough assessment of your board’s work can lead to ongoing improvement—for the board and for the hospital oversees.
Questions for Governing Boards to Consider
- In what ways are our self-assessment results an accurate or inaccurate reflection of our board’s performance over the past year?
- What was surprising about our results?
- What should we include in our action plan to address the identified opportunities for improvement?
- What strengths does our board or council want to build upon?
- How should be build education into our meetings in the coming year that will address the identified areas?
