Leadership and Governance in Healthcare
Boards in the healthcare space are feeling the same regulatory pressures as other types of organizations. The emphasis on leadership and governance has healthcare boards caucusing around boardroom tables with the goal of taking a stronger approach toward identifying the factors that contribute to successful outcomes in healthcare and how to implement them.
Improving leadership and governance in healthcare requires appropriately allocating resources even when they’re scarce, having clear objectives, and ensuring that boards have the right parameters and empowerment to make decisions.
According to Dan LeSueur, Vice President of Client and Technical Operations of Health Catalyst, four principles lay the foundation for transforming leadership and governance in healthcare. They are:
- Engaging the right stakeholders
- Establishing a shared understanding of objectives
- Aligning incentives with the rules of engagement
- Practicing disciplined prioritization
Here’s a more detailed look at how it works:
Engaging the Right Stakeholders
The impetus for healthcare organizations to take action to improve leadership and governance often comes on the heels of an event such as legal action, a patient being harmed, or the company missing its targets or benchmarks. An increased focus on improving leadership and governance in healthcare may also stem from a top leader’s, such as a CEO or other visionary’s, desire for excellence.
Improving leadership and governance in healthcare organizations requires boards to create a call to action for an improvement strategy to actively draw out the best people with the right mix to serve on a task force. The group’s initial goal is to create a shared vision of improved leadership and governance in the healthcare space. The call to action establishes a starting point for all team members. The best approach to the call to action is to put it in writing and communicate it widely through meetings, leadership workgroups, mass communications, and paper or electronic announcements. Communications should flow up and down the ranks, as well as across the ranks, to vet a broad interest in the task force.
The task force should focus recruitment on a wide variety of stakeholders to ensure that all members of the group have a voice in aligning and executing the vision. Recruits should include a mix of stakeholders who will benefit from the initiative, as well as those who feel the burden of the expense. Task force leaders should also seek the buy-in of owners of scarce resources, which will be critical to the group’s success.
It’s also necessary for the task force’s leader to have core competencies, including the ability to stand alone, take risks and present new ideas. An effective leader will keep early processes easy to follow. The group’s facilitator must be able to lead the group successfully through break-through concepts and major shifts and then lead them to take the next best steps regardless of differing opinions within the group. A leader who has the willingness and a comfort level in taking risks makes it easier for others to join in like-minded thinking. Early adopters of the process set the stage for new ideas to transform into standard parts of operations.
LeSueur likes to think of innovative thinkers as the Paul Reveres of the creative process. The first few followers create a snowball effect of shared objectives.
Establish a Shared Understanding of Objectives
Once a well-rounded group has been established, they can get to work identifying the types of high-level opportunities that lead to improving outcomes. The leader needs to gain agreement with where they should start and keep the focus area broad in the beginning. The group can then prioritize the opportunities using data and strategy as instruments. It’s of utmost importance for the group to consider whether the opportunities they’re considering align with the organization’s strategic focus.
This planning stage requires the group to assess the organization’s readiness and capabilities, which they should tackle early in the process so as not to stall the rest of their work. A self-assessment conducted by a third-party expert will help identify the processes, methodologies, infrastructure, skills and cultural factors that will assist the group in achieving its objectives. This step will also highlight potential weaknesses. In all, the assessment will ensure that the group is prepared to pursue the path to managing risks and setting a course for an improvement strategy.
Align Incentives and Rules of Engagement
LeSueur encourages participants to identify and adopt a consistent methodology as an improvement training plan. Due to its high level of security, a board portal system by BoardEffect provides the ideal platform for the group to do its work confidentially. He also notes that accomplishing this may require some type of formal training for the group.
Success of this plan requires all members to align their incentives by embracing the same vision, goals and accountabilities. The group may decide to establish a compensation or incentive structure to encourage clinicians, data experts and other participants to work on the improvement strategy while keeping their other responsibilities in balance.
The group should anticipate and eliminate situations where members feel conflicted because of the negative impact on their careers or personal lives. The best way to tackle this is to make improvement work and goals part of their job description rather than making work appear optional or as add-ons. The group will need to keep polar issues in balance, particularly where opposite forces block progress.
Practice Disciplined Prioritization
The fourth and final principle is to analyze opportunities, determine priorities and allocate resources. The best approach to prioritizing resource allocation decisions is to develop a rubric and use it consistently. The group can then identify key resources that the healthcare system needs, especially with regard to high-value assets where the supply doesn’t match the demand.
By prioritizing teams, the group builds strength, creating a snowball effect that will extend and sustain improvement. The final steps in the process are for the group to establish a plan for communicating progress, plan regular reassessments and seek opportunities to share their success.
These four principles lay a strong foundation for healthcare organizations to improve their leadership and governance, which will help them weather storms and uncertainties. Task forces will require leadership, a solid understanding of their objectives, priorities driven by strategy, and rewards to develop the proper structure that leads to success.