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The Governance Institute Releases 2019 Biennial Survey Results Highlighting Governance Structure in Hospitals and Health Systems

Findings reveal widespread adoption of governance practices, with room for growth

The Governance Institute, a service of NRC Health, has published the results of its 2019 Biennial Survey on governance structure in hospitals and health systems around the country. This year’s survey focused on uncovering how board structure, culture, adoption and performance of recommended governance practices can help hospitals and health systems move further toward care delivery transformation to better align with the future of healthcare.

The individual board members of 244 not-for-profit acute care hospitals and health care systems gave their feedback to the biennial survey, providing valuable insight into how healthcare boards conduct their business and perform against value-based care delivery models. The report found that while healthcare organizations are increasingly making the necessary changes to manage population health and value-based payments, Duty of Care is the most widely adopted fiduciary practice across all types of organizations.

Other major findings include:

  • Board size continues to decrease – The average hospital or health system board is down to 12.4 members compared to 12.9 in 2017. Ten to 15 members is the ideal size to balance out quick decision-making with diverse backgrounds and perspectives. However, boards responding to this survey have fewer clinician board members than in years past.

  • Financial Oversight still has highest performance and adoption rates – Boards gave themselves the highest scores in being sufficiently informed in financial matters prior to making any major decisions or giving approvals.
  • Boards need to set aside more time for active discussion, deliberation, and debate about their organization’s strategic priorities – Findings continue to show a strong relationship between more time being spent on strategic priorities during board meetings and higher overall board performance.

The survey is designed not only to highlight how boards are operating but also to pose internal questions and help boards who are looking to assess their culture and adoption of specific practices and identify key areas for improvement.

To access the complete biennial survey, click here.