by Steve Gordon, MD

The Challenge 

How does the Board of Directors of a complex healthcare organization objectively assess the fitness of its own oversight and boost efficacy? Central City Concern (CCC) had been serving adults and families affected by homelessness, poverty and addictions for 40 years. The board agreed that their governance model wasn’t broken, but felt it was time to take a fresh, holistic look at its effectiveness. They invited Point B to share our extensive knowledge of governance challenges and best practices in the non-profit healthcare space through a rigorous and thoughtful review process, leading to a board better equipped to fulfill its role and laying the groundwork for a vibrant future.

A bias-free zone

With CCC’s governance committee as our primary touchpoint, we first gathered information by meeting with key executive staff and conducting a customized board survey. This led to 1:1 interviews between Point B and board directors, something which proved to be extremely valuable in generating rich dialog and unearthing issues. “There’s something both cathartic and safe, having that conversation with a third party,” said Governance Committee Chair Andy Davidson.

Energized through participation

After compiling the feedback, Point B led an offsite work group of board members and executive staff to focus on issue prioritization, identification of quick wins, and long-term plan development. A near-universal concern had emerged: board members didn’t have enough time to debate the growing number of high-stakes, big-dollar issues coming before them. With this in mind, the group generated ideas around effective board meeting structure, realistic agendas, committee utilization, expectation setting, board succession planning, and more. All board members were invited to the retreat, which resulted in additional wins. “Some board members who are not a part of the Governance Committee  engaged in a pretty big way,” Davidson said, noting that the exercise created a cadre of directors that the governance committee can rely on for candid feedback about the board’s performance going forward, and possibly even a pipeline of future officers for the board.

Right-time inclusion of stakeholders

Point B understood the importance of socializing the ongoing work with the board and made presentations to them along the way. When it came time to bring the completed effectiveness action plan forward for the board’s consideration and approval, there were no surprises. The committee’s recommendations were unanimously approved, including a commitment to reconsider governance effectiveness annually, cementing continuous improvement as part of the board’s DNA.

Key to Point B’s successful strategy was tapping into the right resources at the right time throughout the process. “The board appreciated being asked and being given the opportunity to have a hand in the process together with the governance committee. And most importantly, they were appreciative that we brought in a good governance expert to lead us through the process,” Davidson said. And when Point B handed off the plan for implementation, it was to a board with a collective sense of greater confidence in themselves and their capacity to respond to challenging healthcare opportunities.