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Lee Memorial Health System Board of Directors
Education Workshop Tuesday, January 20, 2015
12:30 p.m. – 2:00 p.m.
BOARD OF DIRECTORS
OFFICE 239-343-1500
FAX: 239-343-1599
13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912
CAPE CORAL HOSPITAL
GULF COAST MEDICAL CENTER
HEALTHPARK MEDICAL CENTER
LEE MEMORIAL HOSPITAL
GOLISANO’S CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA
THE REHABILITATION HOSPITAL
LEE PHYSICIAN GROUP
LEE CONVENIENT CARE
BOARD OF DIRECTORS
DISTRICT ONE
Stephen R. Brown, M.D.
Therese Everly
DISTRICT TWO
Donna Clarke
Nancy M. McGovern, RN, MSM
DISTRICT THREE
Sanford N. Cohen, M.D.
David Collins
DISTRICT FOUR
Diane Champion
Chris Hansen
DISTRICT FIVE
Jessica Carter
Stephanie Meyer, BSN, RN
AGENDA
BOARD OF DIRECTORS
EDUCATIONAL WORKSHOP
January 20, 2015 1:00 p.m.
The Ritz-Carlton 280 Vanderbilt Beach Road, Naples FL 34108
012015 BOARDWORKSOP\AGENDA(FINAL).doc Page 1 of 1
1. CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) Lee Memorial Health System Board of Directors, sitting as the Lee Memorial Health System (LMHS) Board of Directors for Gulf Coast Medical Center & Lee Memorial Hospital/HealthPark Medical Center and the Board of Directors of its subsidiary corporations, including but not limited to Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc.
2. THE GOVERNANCE INSTITUTE – BOARD SELF-ASSESSMENT RESULTS (Ritika Golej- Account Manager)
A. Overview of Lee Memorial Health System Board Self-Assessment Results B. Governance Development Plan C. How The Governance Institute can Best Support Lee Memorial Health
System
14. Date of the next Meeting:
Thursday, January 29, 2015: 1:00pm Finance Board & Full Board of Directors Gulf Coast Medical Center – Boardroom
13685 Doctors Way, Ft. Myers, FL 33912
15. ADJOURN (Sanford Cohen, M.D., Board Chairman)
2
• Mission
– To provide trusted, independent information to board members, physician
leaders and healthcare executives to help them better lead and govern
their organizations
• Non-Profit Healthcare Organizations
– 1064 members as of July 2013
The Governance Institute
32%
16%
44%
8%
Member Breakdown
Systems
Subsidiary
Community
Critical Access
3
The Governance Institute
Assessments
Research and
Publications
Board Education
Portal
National and Regional
Conferences
• Board Self-Assessment
• Readiness Assessment
• Foundation Board Assessment
• National Benchmarking
• Trusted, 3rd- party,
member-driven content
• Case studies
• Largest study on
Governance Structures
and Practices
• National Expertise
• Didactic & Interactive
• Networking for trustees,
physician leaders,
executives, and
governance support staff
Tools and Resources
• TGI information distributed through
portal
• SAS 70 Type II certified network servers
• #1 board portal in the healthcare
industry
Assessments
Research and
Publications
Board Education
Portal
National and Regional
Conferences
• Board Self-Assessment
• Readiness Assessment
• Foundation Board Assessment
• National Benchmarking
• National Expertise
• Didactic & Interactive
• Networking for trustees,
physician leaders,
executives, and
governance support staff
• TGI information distributed through
portal
• SAS 70 Type II certified network servers
• #1 board portal in the healthcare
industry
4
Job Description
“Keeper of Governance Integrity”
Leadership
Role Clarification
Liaison
Meetings
Board Conduct
Education
CEO Evaluation
Self-Evaluation
5
GovernanceInstitute.com
Session Objectives
5
• Review and Discuss– Overview of the Lee Memorial Health System Board Self-Assessment Results
• Governance Development Plan – Strategies and Recommended Practices for Improvement
• Overview of Governance Institute Resources– Discussion of How The Governance Institute can Best Support the Ongoing
Efforts of Lee Memorial Health System
8
Features of the Assessment
• Board members are asked, “On a scale of 1-10, with 10 being high, please rate the effectiveness of the board.”
• In the results, average top box scores are provided for each category.
Overall Board Effectiveness Ratings
• If there was one improvement the board could make to be more effective in the upcoming year, what would that change be?
• What suggestions do you have for ongoing education topics?
Open-Ended Questions
• Provides data of what the board rates as its performance at the highest level possible.
Top-Box Ratings
8
9
GovernanceInstitute.com
Effectiveness Rating
Effectiveness Rating: On a scale of 1–10, Lee Memorial Health System’s board rated the effectiveness of the board overall:
Response Rate: 8 out of 9 board members responded to Lee Memorial Health
System’s board self-assessment, resulting in a response rate of 89%.
8.1
7.6
0 2 4 6 8 10
Overall Score
Lee Memorial HealthSystem
National Benchmark
10
Overall RatingsOverall Ratings are calculated
by combining the overall “top-
box” ratings for each category.
Those responses are then
compared to The Governance
Institute’s national database of
organizations that completed
the board self-assessment.
Top-Box RatingsTop-Box ratings reflect what
percentage of your board rated
its performance at the highest
level possible, or the top-most
rating.
Overall Ratings
12
Strategic Governance: Strategic Planning
Requiring that major strategic initiatives specify measurable
criteria for success and individual accountabilities
63% 13% 25%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
13
Strategic Governance: Strategic Planning
Setting annual goals for board performance that support the
organization’s strategic direction/plan
13% 25% 38% 25%
Very Effective
Effective
Neutral
Ineffective
Very Ineffective
14
Strategic Governance: Strategic Planning
Best Practices for Increasing the Board’s Role in Direction Setting & Planning
Three foundational board
practices to lead strategic
direction efforts within the
organization:
1. Educated Board Members
2. Active Board Involvement
3. Stakeholder Engagement
Board Involvement in Strategic Planning
15
Strategic Governance: Strategic Discussion
Spending more than half of most board meetings discussing
strategic issues as opposed to hearing reports
25% 13% 50% 13%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
16
Strategic Governance: Strategic Discussion
Strategic Issues: Determine what your organization should achieve, undertake,
pursue a goal and/or initiative.
Operational Issues: Determine how your organization should achieve,
undertake, and/or pursue a goal and/or initiative.
• Hold each other accountable for staying informed and engaged
• Prioritize discussion over reporting (e.g. assume all have read the board packet and set
the expectation that there will be no verbal reports of materials that were provided
before the meeting)
• Develop a board calendar based on the strategic plan with a specific strategic topic
identified for each board meeting
17
Strategic Governance: Mission Statement & Fiduciary Duty of Obedience
Reviewing the hospital’s mission statement annually to ensure its
ongoing appropriateness
25% 38% 25% 13%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
18
Strategic Governance: Mission Statement & Fiduciary Duty of Obedience
Considering whether a major decision will impact the
organization’s mission before approving it
13% 50% 13% 25%
Very Effective
Effective
Neutral
Ineffective
Very Ineffective
19
Strategic Governance: Mission Statement & Fiduciary Duty of Obedience
Duty of Obedience: Ensure that the organization’s decisions and activities adhere to the fundamental
purpose and the mission of the organization.
What does this
mission statement
mean to you?
Lee Memorial Mission Statement:
To continue to meet the health
care needs and improve the
health status of the people of
Southwest Florida.
20
Strategic Governance: Open-Ended Responses
“Spending more than half of most board meetings discussing strategic issues as opposed to hearing reports”
“Requiring that major strategic initiatives specify measurable criteria for success and individual”
“More strategic discussion”
If there was one improvement the
board could make to be more
effective in the upcoming year,
what would that change be?
What suggestions do you have for
ongoing board education topics?
“Strategic dialogue & learning to ask
more meaningful questions of staff.
Strategic Planning!!”
21
Strategic Governance
Recommendations:
• Strategic Planning Education on the board’s role in planning & oversight
Clear communication on ongoing initiatives from the strategic plan
• Strategic Discussion Effective Board Meetings
Ongoing Education to Help Frame Board Member Discussion
• Mission Statement & Fiduciary Duty of Obedience Chairman’s Report focused on the board’s duty of obedience to the mission
Present strategic initiatives and how the tie into the mission of the organization
*Helpful Resources: Elements of Governance® Effective Board Meeting, Elements of Governance® Strategic Planning and Direction Setting, board portal, Leadership Conferences, publications and content, sample agendas
22
Strategic Governance
Effective Board Meetings• Materials in advance
• Timed & labelled agendas
• Strong chair leadership
• Post-meeting evaluation
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Strategic Governance
Strategic Retreats
Conferences:
• National perspective on the changes & challenges facing the
industry
• Opportunity to network with peers
*Conducting an Educational Retreat onsite at a conference can
allow the board to unpack what they are learning and directly
apply it to Lee Memorial Health System.
The Governance Institute’s education programs are
designed to support innovative leadership
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GovernanceInstitute.com
Ongoing Education & Development• Quarterly White Papers
• Bi-monthly BoardRoom Press newsletters
• Online e-Briefings newsletter
• Orientation Resources
• DVDs programs
• Webinars
• E-Learning Courses
• Research
• Member Editorial Board
• Elements of Governance, healthcare fundamentals
Strategic Governance
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GovernanceInstitute.com
CEO Succession Planning
Requiring the CEO to have a written and current succession plan
13% 38% 13% 25% 13%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
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GovernanceInstitute.com
CEO Succession Planning
Boards engaged in thorough leadership transition planning are:• Focused on the future and the role a new
CEO will play in leading the organization forward
• Proactive and intentional about management development and building executive competencies
• Focused on ensuring an effective, smooth transition
• Determined to maintain high performance through the transition period
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GovernanceInstitute.com
CEO Succession Planning
Recommendations:
• Review, Update, and Implement a CEO
Succession Plan, elements to include: Timetable
Search and Selection Process
Transition Plan
Retention Planning
CEO Employment Agreement
Communication Plan
*Helpful Resources: Elements of Governance® Succession
Planning, 2nd edition
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GovernanceInstitute.com
Educational Opportunities: Policies
Enforcing a written policy on confidentiality
13% 50% 38%
Very Effective
Effective
Neutral
Ineffective
Very Ineffective
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GovernanceInstitute.com
Educational Opportunities: Policies
Having written policy(ies) outlining the approach to competition
and conflict of interest for the organization’s physicians
50% 25% 25%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
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GovernanceInstitute.com
Educational Opportunities: Policies
Reviewing all sentinel events and root cause analyses promptly
38% 25% 25% 13%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
33
GovernanceInstitute.com
Educational Opportunities: Policies
Having a board policy establishing the board member’s role in
fund development and/or philanthropy
13% 25% 63%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
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GovernanceInstitute.com
Educational Opportunities: Policies
Recommendation:
• Education for the board on the following policies: Confidentiality Policy
Physician Competition and Conflict-of-Interest Policy
Fund Development/Philanthropy Policy
Sentinel Event Review Process
• Ensure access to policies for future reference
• Education for the board re: policy review process every three years
*Helpful Resources: Board Portal
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GovernanceInstitute.com
Educational Opportunities: Board Leadership Succession Planning
Having a formalized board leadership succession plan to develop
and select officers
13% 13% 38% 38%
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
36
GovernanceInstitute.com
Educational Opportunities: Board Leadership Succession Planning
Recommendation:
• Education for the board on Lee Memorial’s
Health System’s process for appointing
future board leaders, includingClear process for selecting officers
List of competencies and prerequisites for officers
*Helpful Resources: Elements of Governance®
Planning for Future Board Leadership
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GovernanceInstitute.com
Educational Opportunities: Physician Leadership
Ensuring appropriate physician involvement in governance
25% 25% 13% 13% 25%
Very Effective
Effective
Neutral
Ineffective
Very Ineffective
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GovernanceInstitute.com
Educational Opportunities: Physician Leadership
Recommendation:
• Education session on physician leadership, to
include: Educational resources provided by The Governance
Institute
Discussion on the role of physician leaders in governance
at Lee Memorial Health System
*Helpful Resources: BoardRoom Press® Special Section “The Board’s Role in Physician
Leadership Development” by Elaine Zablocki, BoardRoom Press® article “Beyond Governance
to True Physician Leadership Engagement” by Chris Van Gorder
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GovernanceInstitute.com
Educational Opportunities: Physician Credentialing
Setting criteria, independent of the medical executive committee,
to guide medical staff recommendations for physician
appointments, reappointments, and clinical privileges
13% 38% 13% 38%
Very Effective
Effective
Neutral
Ineffective
Very Ineffective
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GovernanceInstitute.com
Educational Opportunities: Physician Credentialing
“One of the strongest
mechanisms for ensuring
quality is rigorous
credentialing of the
practitioners who will
provide care in the
institution”-Todd Sagin, M.D., J.D.
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GovernanceInstitute.com
Educational Opportunities: Physician Credentialing
Recommendation:
• Define and conduct education on the role
of the board in the credentialing process
*Helpful Resources: Elements of Governance® Physician Credentialing: An
Orientation Manual for Board Members
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GovernanceInstitute.com
The Governance Institute Resources
Intentional Alignment Board Recruitment & Retention
Orientation – Board Basics
Graduate Level Governance
Extensive Governance Research
Peer-to-Peer Access
Best Practice Recommendations
Governance Support Resources
Execution & Access Board Meeting Books
Committee Workspace
Synchronized Calendar
Polling & Surveying
Ongoing Communication
Secure Storage Space
National Exposure Current Healthcare Knowledge
Interaction
Expert Speakers
Evaluation & Improvement Largest Comparative Database
Custom Development Plan – Create Goals
Fiduciary Board
Advisory Board
Foundation Board
Committee Evaluations
45
GovernanceInstitute.com
Ritika Golej
Account Manager
The Governance Institute
(877) 712-8778
Thank you!