Best Practices in Governance - ACHD€¦ · · 2018-01-30Good Governance Enables ... 6. Making...

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Introduction to SMART GovernanceAssociation of California Healthcare DistrictsLeadership AcademyFebruary 8, 2018

Jim RiceManaging DirectorGovernance and [email protected]

Best Practices in Governance


Learn about how your Board can adapt SMART board work practices to ensure an effective delivery of services, collaborating with stakeholders and sharing resources amongst partners in the community to achieve the Board’s mission in a changing policy and political landscape.


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Good Governance Enables Stronger Health Systems and Greater Health Impact

The Brown Act Seeks to Protect the Public Interest as You Govern.

Governance is a structured process wherein a group of people (usually referred to as a governing body/board) make decisions about policy, plans and rules of collective action that wield power and resources intended to define, promote, protect and achieve the health mission of an organization, system, program, country or institution.

Implementing this definition requires a focus

on essential practices

These practices occur in many venues : Public and Private All Health Issues All levels


SMART Governance for Health:

S…Stakeholder engagedM…Mission drivenA…Accountability expectedR…Resource mobilizedT…Transparency enabled


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Defined Populations with Diverse, Social Determinants of Health Risks

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Behavior Change Protocols for Chronic Disease

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Expanded Continuum of Care Technologies and Facilities

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New Strategic Alliances and Co-Ventures

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New Teams of Collaborative Health Workers

08Electronic Health

Records07

External Value Based

Bundled Payments

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Internal Incentive Compensation,

Recognition and Reward Systems 06

Boards of Healthcare Districts Require New Capabilities & Investments

Re-inventing Care and Risk Management

These 8 imperatives call for new Strategic Partnerships and new Models of Governance withbolder and wiser governance practices

New Board Room Conversations


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Logic Model of Good Governance


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System Board

Hospital Senior Living

Health Center

Home HealthPhysicians

FoundationAdvisory Council

Need Governance Authority Matrix Competency Mapping Themed Meeting Calendar Smart “Group” Charges and Work Plans Board Self-Assessment

Many Types of Governing Bodies in California

Community Health Partnerships

Housing Schools Food & Water


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Four Essential Practices of Good Governance

Group discussions about these practices.

What can leaders do to improve effectiveness in all areas?


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Continuous Governance Enhancement1. Cultivating governance competencies2. Building diversity in the governing body3. Organizing governance orientation and

continuous governance education4. Performing regular governance

assessments5. Running effective governing body

meetings6. Making governance policies7. Using governance technologies8. Working for continuous governance

enhancement


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Essential Prerequisites:


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Ongoing Assessment

and Refinement

Board Role

Board Composition KSA Matrix

Size & Structure of

Board

Excellent Committees

Board Information

System

Great Meetings: Calendars Agendas

Board Job Descriptions

Terrific Orientation

Process

Excellent Ongoing

Education Program

Market Needs & Strategic Plans for Health

Great Board Work Drives Good Organizational Results.Great Infrastructure Drives Great Board Work.


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Many Structures & Roles:

1. System or Corporate Board2. Regional Board3. Local Institution Board4. Subsidiary Boards5. Advisory Boards6. Foundation Board7. Co-Venture Board8. Community Partnership Board


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System Board

Hospital Senior Living

Health Center

Home HealthPhysicians

FoundationAdvisory Council

Need Governance Authority Matrix Competency Mapping Themed Meeting Calendar Smart “Group” Charges and Work Plans Board Self-Assessment


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Responsibility Continuum:

Decide Influence Advice

Community Needs AssessmentStrategic PlanningProgram Quality PlanningConsumer Experience MappingProgram Performance AssessmentFinancial Planning & BudgetingPhilanthropyCEO Hiring, Performance Review


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1.Mix of Roles and Contributions2.Need to Optimize Community Engagement3.Exploding Enterprises in Accountable Care4.Need for Many Competencies5.Work Load Needs to be Shared6.Moderate Numbers Making Decisions7.Tax-Exemption Pressure

Why have Mix of Board Types?


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Board Work Issues The Challenges Strategic Imperatives Implications for Your Strategic Actions & Investments

Social Determinants

Experience Mapping

Purchaser Value

Boundary Spanning

Transparent Results

For your realities, how might you best respond to ensure your success?

Chronic Care & Care ContinuumHealth Gain not just Health CareUnfunded MandatesNew PartnershipsUnderlying poverty

Impatient & Discerning SegmentsRetail Delight MetricsTotal Experience MapsCross Industry InsightsCRM Systems and Attitudes

Value MetricsPower Imbalance & Market PositionCompete on Costs & QualityCredit & Out-of-pocket SpendingRevenue Cycle Management

Boards and New Partners-StakeholdersGrowing Regulatory Oversight & RiskAddress Eroding Board TalentGovernance Best PracticesGovernance Portals

Published Quality ScoresPublished PricingActivist MediaGlass Door VisibilitySocial Media Advances

1. Enhance Joint CHNA Partnerships2. Strengthen Philanthropy Beyond

System3. Study Foster McGaw Lessons4. Study Collaborative Governance5. Energize Political Advocacy

1. Establish Consumer Advisory Councils2. Study Art of Experience Mapping3. Bring in Speakers on “Experience”4. Adjust EMR for CRM Features5. Quarterly Reward Team Performance

1. Convene Payer Purchaser Roundtable2. Invest in More Price Transparency3. Publish Performance Metrics4. Study Branded Visa Cards for Pockets5. Invest in Annual Payer Report on Value

1. Develop “Governance Enhancement Plan”

2. Enhance Board Portal Functions/Use

3. Conduct Mock OIG/RAC Audits

1. Conduct Results Oriented Annual Social Media Plan and Budget

2. Convene Media Advisory Council3. Re-invent Community

Roundtables

Navigating The Journey: A Trustees’ Roadmap

http://www.iconarchive.com/show/red-orb-alphabet-icons-by-iconarchive/Number-1-icon.html











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Governance Innovation: a five-part series


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Dare to Compare: a three-part series

Canadian Hospitals England Hospitals Credit Unions


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Risk Mitigation Framework for Boards


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Governance Authority Matrix


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Distilled Insights from Many Sources:


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Case Study Learning. Study Tours. Strategic Retreats. Design Studios.


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Thank you for all your do for the people that live and work in your healthcare district!

Jim Rice, Managing Director Governance and [email protected]: 612-703-4687

mailto:[email protected]

Best Practices in Governance - ACHD€¦ · · 2018-01-30Good Governance Enables ... 6. Making...

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