Safety nets need large, diverse governance

After declaring that real health reform requires strong governance, the American Hospital Association is touting best practices to help safety-net hospitals improve their governance structures, according to AHA News Now.

Although almost a quarter of surveyed board members and CEOs say their boards are too large to be efficient, a new report from the hospital group urges safety-net hospitals to rethink board size.

Given the more complex healthcare environment and bigger systems, a larger board can help safety nets make governance decisions. For example, Boston Medical Center has 12 board committees with 30 members who can divvy up tasks to govern the merged system, the report noted.

The board composition should have a diverse membership to help reach its goals of controlling costs and improving quality. Diversity allows boards to reflect the demographics and needs of the vulnerable populations treated at safety-net hospitals.

To close the diversity gap, safety nets can reserve a certain number of board positions for representatives of minorities or other key constituent communities, the report noted. For the Hawaii Health Systems Corporation, almost half of its governing board must come from specific regions of the state.

"It is my experience that diversity in all areas allows for better decision making [and] can assist in performance improvement and quality of care delivery," Witt/Kieffer Senior Advisor to the CEO and Senior Vice President Jim Gauss told FierceHealthcare in a previous interview.

However, the AHA report pointed out that placing mandatory qualifications on a large a portion of the board can inhibit selecting the best candidate to fill a vacancy--despite goals of comprehensive expertise and perspectives.

For more:
- check out the AHA report (.pdf) (registration required)
- here's the AHA News Now brief