By Kenneth Kaufman
America is changing in too many ways to count. The political and cultural ramifications of an increasingly pluralistic population are harder and harder to predict and make overall governance of complex healthcare organizations an increasing challenge.
For starters, the definition of healthcare is fast changing, and it now includes not only inpatient and outpatient clinical care but also the broader demands of public health. And that public health definition gets broader and broader every day, and now encompasses the COVID-induced mental health epidemic and the nationwide accelerating gun violence.
This widening definition of healthcare is demanding a new board vision of service to its community and a new associated strategic plan that re-sets the next ten years of American healthcare.
In the past, the board’s job was relatively straightforward: to monitor and oversee the internal workings of its hospital and health system. That remains a key board role. But in 2021, the business externalities are in ascendancy. No hospital board can set a correct strategic direction without accurately recognizing and reacting to unprecedented external business conditions. These externalities are remarkable and at the least include:
Finally, every board must recognize the power and influence of a fast-changing stakeholder environment. In the recent past, healthcare system stakeholders included the board, management, and doctors—period.
But now, the stakeholders that impinge on health system operations and policy include patients, employees, sub-groups of employees, multiple communities, local government, state government, the federal government, political movements, religious influences, other not-for-profit organizations, BIG media, and social media. It all comes together to form an essentially uncontrollable business environment that seems to change by the day and sometimes by the hour.
When you add the external business conditions to the long line of activist stakeholders, you get a rather new list of board challenges and responsibilities that include:
It’s hard to be a hospital board in 2021, and it’s not likely to get easier anytime soon.
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