How Should Hospital Boards Conduct Board Self-Evaluations?

Hospital boards that choose to conduct board self-evaluations have much to learn about how well the board functions as a unit. Some hospitals are required to conduct annual board self-evaluations, as well as self-evaluations for major committees. For hospital boards that aren’t required to conduct board self-evaluations, best practices encourage boards to do them regularly. Most boards choose to perform self-evaluations annually, but some boards do them less often.

Various types of self-evaluations are available. Some boards prefer to conduct a comprehensive self-evaluation every two or three years. Hospital boards should consider where in their development cycles to incorporate board evaluations.

The care of patients requires hospital boards to make sure that their facilities have continuous processes, systems and structures in place that ensure quality patient care.

Board self-evaluations are aimed at making sure that there is a quality improvement process in place for the boards making decisions about patient care. The process should help boards learn if they’re underperforming and what they can do to improve. The self-evaluation process should encourage board directors to hold themselves to the same level of accountability for quality care as they expect of hospital managers and employees.

How Hospital Boards Benefit From Self-Evaluations

Specifically, board self-evaluations help boards identify gaps in their performance. The results of the evaluations will point out potential issues and concerns, as well as specific areas where boards can improve their performance.

Boards that successfully complete the self-evaluation process will gain valuable benefits. In making changes based on the results, boards will work together more effectively, which will promote the overall enhanced performance of hospital employees. When done well, the process should help the board trustees to gain better agreement on the board’s role and responsibilities and bring board directors closer together. Reviewing results should strengthen board communication and understanding and lead to a better sense of cohesiveness. Most boards find that completing board self-evaluations and working together to implement changes for improvement reignites individual trustees’ dedication to the board.

Areas for Hospital Boards to Evaluate

Boards can expect the best results when they pursue a self-evaluation course that drives quantitative and qualitative results. Before deciding on questions for the evaluation, boards should identify the most critical factors for governance success. It’s helpful to acquire broad-based and insightful input from trustees about the fundamentals of governance leadership. Some boards find that it works best to secure input from the board anonymously.

Boards can expect that evaluations may bring major issues and ideas out from under the surface. The results should help boards address them collaboratively and objectively in mutually supportive ways. Boards will learn better if they’re on the same page on the major issues; assess whether any of the major issues may affect their fiduciary duties and responsibilities; and point out areas where boards may need to pursue board educational and development opportunities.

Hospital boards typically choose the same time of year to perform their board self-evaluations.

Some hospital boards find that the best time to do it is in the weeks or months before the annual board retreat. Board retreats provide an accepting environment for discussing evaluation results and making plans to implement changes. Retreats are typically informal and relaxing. Board members attend board retreats with a spirit of optimism and eagerness to do their best in the coming year. The environment creates an environment of openness to accept constructive criticism and change.

How to Conduct Hospital Board Self-Evaluations

Boards will need to decide who will take responsibility for overseeing the evaluations, gathering results and guiding discussions of the results. Usually, the board chair, governance committee or corporate secretary takes the lead.

One of the most common types of board self-evaluations uses a survey format, either on paper or online. Another popular method for board self-evaluations is to do interviews with each director. Boards can use survey questions as the basis for the interviews. Still another option is to arrange for a full board discussion, which may work best when hospital boards enlist the help of a qualified, third-party facilitator or evaluation firm. Boards have the option of combining these methods as well, depending on their needs and comfort level.

One of the most contemporary methods of board self-evaluation is to utilize electronic keypads on which board members can plug in their answers simultaneously and anonymously in real time. Software programs may allow boards to get the results immediately, so they can complete the process with record efficiency.

What Areas of Trustee Performance Should Hospital Boards Test?

According to The Walker Company, a healthcare consulting firm, hospital boards should address four main areas during their evaluations. The four areas are:

1. Assessment of overall board performance in several areas of leadership accountability
2. Assessment of committee performance
3. Identification of issues and priorities facing the board
4. Assessment of individual trustee performance, including a peer evaluation

The Walker Company also suggests that boards assess the following areas of leadership responsibility:

• Mission, values and vision
• Strategic direction
• Leadership structure and governance processes
• Quality and patient safety
• Community relationship
• Relationship with the CEO
• Relationships with senior medical staff
• Financial leadership
• Community benefit and health

Boards will get the most out of their evaluations when they take a customized approach. Hospital boards should view the previous lists as a base list for developing a customized list of their own.

Self-Evaluations for Major Hospital Board Committees

The major board committees have a strong influence on the board’s decision-making, which is why it’s important for boards to perform self-evaluations on the vital committees. Some hospital boards are required to conduct self-evaluations on certain committees. In other cases, boards can decide which committees they want to evaluate. The most common committees for boards to evaluate are:

• Quality committee
• Compensation committee
• Audit committee
• Finance committee

The approach for evaluating committees is a bit different than for full board evaluations. The questions should be based on the charter and goals of each committee. Some of the questions may be open-ended ones that explore how the committee can improve its performance.

How hospital boards perform evaluations is vitally important, but it’s important not to skim over the rest of the process, which is evaluating the results, reviewing them and deciding how to make meaningful improvements. It’s usually beneficial to compile the results in a database and report them collectively and anonymously. Boards may decide to review the results at a regular board meeting, at a special meeting or at the annual board retreat, as noted earlier.