Monday, May 27, 2013

Exceptional board culture: Blue ribbon health care recommendations

What are the characteristics of an effective board culture? How do we recognize those signs of a board culture that is ineffective or, worse, downright dysfunctional?
I've been batting variations of those two questions around a lot here lately, sharing various perspectives that help to shed some light on the complex web of relationships in our boards and the ways in which they enhance or challenge the work undertaken there. I'm always on the hunt, looking for great resources to share with you and to inform the next phase of my research on boards.

Recently, I encountered a new-to-me report that offers a particularly concise set of factors on both ends of the board effectiveness continuum: The Center for Healthcare Governance's 2007 Blue Ribbon Panel report, "Building an Exceptional Board: Effective Practice for Healthcare Governance.

Within a section titled "Building and Sustaining a Proactive and Interactive Board Culture" (pp. 12-16) are the lists of characteristics of effective and ineffective board cultures.

Characteristics of an effective board culture

  • "Commitment to mission"
  • "Well-defined governance processes"
  • "Broad skills and diverse backgrounds"
  • "Organizational performance focus"
  • "Strategic focus"
  • "Engagement"
  • "Ongoing education"
  • "Explicit, high-performance expectations"
  • "Constructive dialogue and debate are welcome" (p. 14)

It's not hard to imagine how each of these characteristics contribute to a healthy, engaging, productive board culture. The list as a whole also offers a standard to which all boards should work (which, of course, is why I'm sharing it here). But, of course, a few stand out to me as especially noteworthy.

When "well-defined governance processes" are accepted and adopted, there is a productive and reliable routine to the work. Boards focus where they need to focus (hint: on policy and big questions, not the day-to-day muck), their meeting agendas are set up to accomplish that, and they understand their respective individual and collective roles.

"Engagement" refers both to the privilege and the responsibility of all board members to play an active role in governance. It's not only showing up and voting, it's also contributing one's unique expertise, connections and outlooks on life.

No surprise: "ongoing education" caught my eye. Note the "ongoing" part of that descriptor. It's more than an obligatory orientation session, a training session "because we must," and calling in someone when we've really mucked up things. It's an ongoing commitment to our own development and out capacity to serve, formally and informally.

The element that most resonates for me this morning is "explicit, high-performance expectations." We and those who serve beside us are committed community leaders. We rise to the expectations set for us. When you (and we) set the bar high, and provide the support needed to succeed, we will succeed. Frankly, I believe this is one of the biggest barriers to optimal board performance. It also may be the one least tied to reality.  We expect little of those who serve today, perhaps based on what may (or may not) have been true of boards. We get little from our current members, because we aren't giving them the respect and the support they need and deserve based on those outdated assumptions. It's a vicious, self-perpetuating cycle that we can break if we really want our boards to govern.

Characteristics of an ineffective board culture


  • "Ineffective meetings"
  • "Unengaged and disconnected"
  • "Passive and reactive"
  • "Unclear priorities"
  • "Decision-making is pro forma" (unanimity is the norm, "go along to get along")
  • "Lack of commitment to mission"
  • "Personal agendas are played out"
  • "Lack of appreciation by management"
  • "Board has difficulty acting as one body"
  • "Board is top heavy with committees, stultifying board structures"
  • "Board members are elected based on social status rather than proven skills essential to the organization"
  • "Lack of creativity" (p. 14)

Many characteristics on this list is basic "groups 101" - and exactly where at least some of our board dysfunctions begin. I've been writing about these and related group dynamics challenges, so I'll leave you with this list and look forward to any insights and experiences that you might want to share via comment.

I could generate several posts from this single, fantastic document. It's chock-full of thought-provoking recommendations that are either directly applicable to boards generally or easy to adapt from the medical context.   Instead, I'll encourage you to download the report, read the "Building and Sustaining a Proactive and Interactive Board Culture" section, and also point out these additional highlights:

  • Recommended board characteristics, skills and experience (p. 15) - a fresh way of thinking about the qualities needed in the boardroom.
  • Stretch practices for exceptional boards (p. 25). Be sure to consider the "deep dive" discussion that they describe here. 
  • Board-stakeholder checklist (p. 30)
  • Developing and using a balanced scorecard for governing (p. 31)
  • Core Competencies Wheel (p. 36). The most comprehensive perspective I've found for thinking about all of the competencies we need in a nonprofit boardroom, provided by Texas Health Resources. If I could, I'd create wall-sized versions of this chart for every board for use in its next recruitment process.
  • Sample position profile: vice president for governance (p.42). Perhaps overkill, at least at the vice president level, for most small to medium nonprofit boards. But A valuable way of thinking about how to institutionalize responsibility for governance processes (and, perhaps, a perfect responsibility for any vice president).
  • Sample board chair position charter (p. 51). Great description of the kinds of qualities and responsibilities that should be embodied in our board chairs.
This post is part of a new occasional series spotlighting the key books and other resources that are influencing my thinking on the group dynamics that impact what happens in the nonprofit boardroom. It is part of my commitment to exploring group process and practice in 2013.

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