Governance - Verse 1

Governance is defined as a shared process of top-level organizational leadership, policy making and decision making. Although the governing board has the ultimate authority and accountability, the CEO, senior management and clinical leaders are also involved in top-level functions. Thus, governance is not a “board only” activity, but rather an interdependent partnership of leaders.

It is the function that holds management and the organization accountable for its actions and that helps provide management with overall strategic direction, and at an informal level it keeps things "glued together."

Reports to the board need to present measures of the processes and performance areas that are most critical to the organization’s mission, vision and strategic and operational goals. These measurements are frequently reported indicators of the organization’s key strategic initiatives and critical processes. Reports generally include the following major topics: financial position, revenues and costs, clinical quality and appropriateness review, service volumes and environmental changes and progress reports on ad hoc committees and ongoing projects.
Increasingly, boards are also informed of quality outcome measurements, ratings and comparisons that may be reported through the media. Many, but not all, of these measurements are provided to the board prior to communitywide dissemination.

Reports should also include evidence of how well the organization performed in meeting its own expectations. Reported measures should include established expectations, tolerance limits of variation and highlighting of variance that exceeds those limits. This is not necessarily the same information as presented to management (e.g., it may be simplified), and it does not have to be the same as similar organizations (that may have different missions and financial constraints). Reports on these measures are generally made in aggregate since board members have limited time to review information .



Of course there is much more to the substance and the form for each organization. Let InterOPERANT have a look. We specialize in this subject as well as strategic and tactical planning for your systems - Financial, Clinical and the key integration points between them.

I'll follow this verse with some very specific examples of organizations I have worked with in developing their governance processes. Governance won't work miracles, but it can be a very effective tool for all healthcare organizations particulairly as it relates to InformationTechnology, capital management and spending, priorities, and project management.


Bader, B.S. “CQI progress reports: The dashboard approach provides a better way to keep boards informed about quality.” Healthcare Executive, September/October 1993, 8-11.

Shortell, S.M. and Kaluzny, A.D. Health care management: Organization design and behavior (5th Ed.), Clifton Park, NY: Thompson-Delmar Learning. 2006

Griffith, J.R. and White, K.R. The Well-Managed Healthcare Organization (6th Ed.), Chicago: Health Administration Press. 2007.

For more information try this excellent podcast, and link. I feel you will find them very useful:

"Peter Weill, director of the Center for Information Systems Research at MIT's Sloan School of Management and co-author of IT Governance, discusses lessons he learned while researching his book":

http://www.cio.com/podcast/102564/What_Makes_for_Good_IT_Governance

also try,

http://www.cio.com/article/355413/IT_Governance_Tips_Help_to_Improve_Executive_Buy_In

Best,

Don Lyons

CEO and Managing Partner