/ en Wed, 30 Apr 2025 02:45:51 -0500 Mon, 25 Nov 24 13:10:33 -0600 /news/headline/2024-11-25-ahas-2024-governance-survey-available-until-dec-9 <p>AHA-member and nonmember CEOs are being reminded to complete the AHA’s 2024 Governance Survey by Dec. 9. The survey, sent via email, provides a profile of the changing landscape of governance in America’s hospitals and health systems. It will benchmark current board structure, practices and culture with previous AHA governance surveys and highlight best practices in the evolving environment. The AHA will produce a report in 2025 highlighting the results of the survey. If you did not receive the survey and want to complete it, please email <a href="mailto:surveysupport@aha.org">surveysupport@aha.org</a>. </p> Mon, 25 Nov 2024 13:10:33 -0600 Governance Effectiveness /leading-safety-aha-quest-quality-series <p>The <a href="/aha-patient-safety-initiative" title="AHA Patient Safety Initiative (PSI)">AHA Patient Safety Initiative</a> proudly presents Leading for Safety, a <a href="#Q4QVideoSeries" title="Jump to the videos">virtual series</a> hosted by <strong>former Saint Luke's Health System CEO and former AHA Board Chair, Mindy Estes, M.D.</strong> Featuring insights from past AHA Quest for Quality honorees, this series explores how health care leaders can drive safer, higher-quality care by fostering a culture of safety and innovation. Combining the prestigious Quest for Quality Prize with the AHA’s Patient Safety Initiative, Leading for Safety provides practical strategies for executive leadership in advancing patient safety.</p><div class="row"><div class="col-md-6 col-md-offset-3"><a href="/about/awards/quest-for-quality" title="Link to Quest for Quality page"><img src="/sites/default/files/inline-images/Q4Q_nohpoe.jpg" alt="Quest for Quality logo" width="100%" height="100%"></a></div></div> @media (min-width:991px) { .field_reusable_cta{ width: 25%; left: 15px; float:left } .container.edp-container .body { width: 75%; padding-right: 15px; float:left } } @media (min-width:771px) and (max-width:990px){ .field_reusable_cta{ width: 40%; left: 15px; float:left } .container.edp-container .body { width: 60%; padding-right: 15px; float:left } } @media (max-width:770px){ .field_reusable_cta{ width: 100%; margin:auto; font-size:12px; } .field_cta_body{ width:75%; display:block; margin:auto; } .panel.module-typeC{ margin-bottom:0px } .container.edp-container .body { width: 100%; margin-bottom:25px } } Thu, 26 Sep 2024 08:00:00 -0500 Governance Effectiveness /news/headline/2024-09-17-ahas-2024-governance-survey-ceos-now-available <p>The AHA’s 2024 Governance Survey is now available for AHA-member and non-member CEOs to complete. The survey was initially emailed to CEOs Aug. 20 and a second message will be distributed in October. The survey provides a profile of the changing governance landscape in America’s hospitals and health systems. The survey will benchmark current board structure, practices and culture with previous AHA governance surveys and highlight best practices in the evolving environment.  A report highlighting the results will be released in 2025 which will include governance trends. The survey will close in mid-November. Email <a href="mailto:trustees@aha.org" target="_blank">trustees@aha.org</a> for additional information.</p> Tue, 17 Sep 2024 15:29:19 -0500 Governance Effectiveness /news/headline/2024-07-08-aha-podcast-unifying-hospital-boards-quality-and-safety <p>In a new “Safety Speaks” conversation, Harry S. Smith, board chair of Valley Health System and member of the AHA Committee on Governance, discusses how Valley Health rearranged its governance system to ensure that quality and patient safety standards were being met across the board. <a href="/advancing-health-podcast/2024-07-03-unifying-hospital-boards-quality-and-safety"><strong>LISTEN NOW</strong></a> <br> </p> Mon, 08 Jul 2024 16:05:33 -0500 Governance Effectiveness /advancing-health-podcast/2024-07-03-unifying-hospital-boards-quality-and-safety <p>In this new “Safety Speaks” conversation, Harry S. Smith, board chair of Valley Health System and member of the AHA Committee on Governance, discusses how their organization rearranged its governance system to ensure that quality and patient safety standards were being met across the board. </p><p>To learn more and sign up for the Patient Safety Initiative please visit <a href="/aha-patient-safety-initiative" target="_blank">/aha-patient-safety-initiative</a></p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00;00;00;14 - 00;00;31;10<br> Tom Haederle<br> E Pluribus Unum - that's Latin for "out of many, one" - is the traditional motto of the United States and printed on the dollar bill. Out of many, one is also the goal for independent hospitals and their boards who merge into larger health systems and may face the challenge of maintaining safety and quality standards that are no longer just their own. </p> <p> 00;00;31;13 - 00;01;06;07<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA communications. Valley Health System serves a sizable patient population in Virginia. It was formerly six separate hospitals, all of which were governed independently by their boards. In this Safety Speak series podcast hosted by Sue Ellen Wagner, vice president of Trustee Engagement and Strategy with AHA, we hear how Valley Health System rearranged its governance system to overcome the hiccups of its growing pains and ensure that patient safety standards were kept up across the board.</p> <p> 00;01;06;09 - 00;01;18;26<br> Sue Ellen Wagner<br> Thank you Tom. Joining me for this podcast is Harry Smith, board chair of Valley Health System in Virginia, and member of the committee on Governance. Welcome, Harry, and thank you for joining me. </p> <p> 00;01;19;03 - 00;01;20;27<br> Harry S. Smith<br> Thank you, Sue Ellen. Happy to be here. </p> <p> 00;01;20;29 - 00;01;26;18<br> Sue Ellen Wagner<br> Great to have you. So can you tell us a high level overview of your health system? </p> <p> 00;01;26;21 - 00;01;58;29<br> Harry S. Smith<br> Be happy to. Valley Health System, and I've been involved with it and its largest subsidiary, Winchester Medical Center for 22 years. In two more years, I will retire. I will have termed out of Valley Health, and as a career banker, I have found health care to be - as a friend of mine said one time - you're performing God's mission. And I don't know of any organization in the world that does what hospitals and health care systems do to care for our population. </p> <p> 00;01;59;01 - 00;02;29;24<br> Harry S. Smith<br> So when I first started this journey 20 some years ago, I was on the Winchester Medical Center board, which is about 83% of the economic engine, the patient base of our system. We had five other hospitals. We did have a system, Valley Health System. We serve nine counties and a city in the northern part of Virginia. And some people will know it as the panhandle of West Virginia. </p> <p> 00;02;29;25 - 00;03;00;21<br> Harry S. Smith<br> So in addition to Virginia laws, rules and regulations, we also deal with West Virginia. So Valley Health System started back in the late 90s as starting to pull together a loose confederation of like-minded small hospitals to become a regional hospital. Over the years, 2 or 3 that we thought might come into that system actually sold to a for profit system, and that was their decision. </p> <p> 00;03;00;23 - 00;03;35;06<br> Harry S. Smith<br> So we ended up with the Winchester Medical Center, which is Level II trauma, to critical access hospitals and then three rural hospitals. It's been fun looking at this growth of this eclectic system of several different types of delivery in two different states. We realized early on, though, that we were somewhat disconnected, even though we had this holding company called Valley Health, we still had its board in six different hospital boards.</p> <p>00;03;35;08 - 00;04;04;06<br> Harry S. Smith<br> And principally they were responsible for their hospital, their operations. They had their own president. For the most part they did some of their financial and some of their accounting, but a lot of that was at the system level. But they were really principally responsible for quality. And so I became more involved and then was on the hospital board at Winchester Medical Center and the Health System Board, I started realizing how complex this was.</p> <p>00;04;04;09 - 00;04;39;01<br> Harry S. Smith<br> It should be more efficient, and we should be able to provide even better quality for our community. And how could we do that? And first is ask questions. One of the first questions I asked of our CEO was how many quality meetings? How many board meetings do you go to in a month? And it was astounding because remember, we had a quality hospital board meeting for each one of those, plus the system, and he was attending all of those, and each one was handling quality at a high level, but with its own standards.</p> <p>00;04;39;04 - 00;05;09;03<br> Harry S. Smith<br> You can't take six hospitals that used to be independent and overnight, put them all under one system and say to their executive team and to their board, you are no longer independent. So that took a process of moving more functions to the system, which we started really with finance and then audit. They then were principally quality. Then it was, we've got to standardize quality.</p> <p>00;05;09;03 - 00;05;41;12<br> Harry S. Smith<br> So Valley Health System hired its chief quality medical officer to system level. And then started working with the individual hospital presidents and their vice presidents of medical affairs to begin that process. As it started, we still were meeting a lot and I'm not sure really moving the needle as positively as we wanted with quality. So we then visited several systems, worked with consultants on how do we do this better?</p> <p>00;05;41;15 - 00;06;06;29<br> Harry S. Smith<br> And what we came up with, what we did was Valley Health System then became the sole member of all of these separate hospitals. So we then evolved into one board, Valley Health System, which is the sole member of the six hospitals with one board. So early when they were independent hospitals, you had a lot of attention to quality, because that's pretty much what they did.</p> <p>00;06;07;01 - 00;06;34;17<br> Harry S. Smith<br> Now it's one big board, not in each community, even though there's some community representation. How is it going to handle quality in a community that might be 70 miles away? That brought through the standardization process. And we did that at the Valley Health level, kind of just doing what we used to do, but now instead of 6 or 7 boards, it's one. Still wasn't working as well or as efficient as we thought.</p> <p>00;06;34;19 - 00;06;57;27<br> Harry S. Smith<br> We then decided to form what we call QMAC. It's the Quality Medical Affairs Committee, which has the full authority of the board. The system board meets six times a year. Credentialing occurs more than six times a year. And we said the hospitals have to exist for credentialing. You just can't disband a hospital. It has to have a board.</p> <p>00;06;57;28 - 00;07;37;20<br> Harry S. Smith<br> Well, its board is the Valley Health Board because it is a sole member-owned hospital. So representatives then of each hospital, their vice presidents of medical affairs, their lead administrators, their chief nursing officers, key physicians serve on the QMAC, Quality Medical Affairs Committee, which has the full authority of the board. And it meets monthly, and it has full authority to do credentialing to review all quality indices, KPIs and we then at the Valley Health Board, when we meet that six times a year, will open</p> <p>00;07;37;20 - 00;08;03;00<br> Harry S. Smith<br> our meeting, will have a consent agenda. And let me go back, if I might, because in one of this morning's presentations talked about the board's priorities as days and days and years and years ago, it may well have been finance. I think we all understand our number one priority is quality, and we have taken a lot of the normal duties and responsibilities.</p> <p>00;08;03;02 - 00;08;28;22<br> Harry S. Smith<br> Even the monthly financial report and the quarterly. And that's in a consent agenda now. So we don't have a long formal presentation on finance. So we save our time and our time is saved really at reviewing quality, educating the board on quality, but also taking time to educate. Our last meeting, we talked a lot about artificial intelligence and its impact on systems and quality and physicians</p> <p>00;08;28;22 - 00;08;58;02<br> Harry S. Smith<br> and don't be afraid of it because it's just a tool. You still will have humans making those decisions. So I then chair the board. We'll go through the consent agenda of those items that used to take an hour or more. We then open the sole member meetings, and that's where the quality report flows up to our system. The chair of our quality committee and the chief medical officer for the system will make that presentation.</p> <p>00;08;58;04 - 00;09;21;20<br> Harry S. Smith<br> And all this information is in our board package, and we have what we call an S-bar. You'll see the report. But then if you want literally the other 200 pages to go with that report, you can pull that up. That committee is populated, as I mentioned, from all of our hospitals are critical care. Our clinical administrators, our physicians assistants, nurse practitioners, chief nursing officers.</p> <p>00;09;21;22 - 00;09;52;22<br> Harry S. Smith<br> So it's very well represented. And that's where the deep dive occurs. That's where the sausage is made. We at the system level who aren't on that committee have to have a very high level of trust, which we do, and have given that committee, again, full authority to act on the board for our quality initiatives, including credentialing. So I know I'm rambling, but just to give you an idea of what this committee does and then how we review it.</p> <p>00;09;52;23 - 00;10;28;25<br> Harry S. Smith<br> So our QMAC committee reviews credentials. Our staff executive committee, which some would call their medical executive: committee minutes and reviews. Our performance improvement committee: harm scorecard quality scores, patient experience scores. They'll have special reports. They'll hear from our VHMG, which is our Valley Health medical group. That's the employed physicians. We have our entity presidents. There will have information that comes at a little bit of recruiting, is epic working as we would sentinel events, serious safety events.</p> <p>00;10;29;01 - 00;10;59;21<br> Harry S. Smith<br> Again, this is for all six hospitals coming to one group. As I mentioned credentialing, we have advanced practice providers involved in that. We hear a report from each department: cardiology, emergency medicine, family, etc. Review in depth the Performance Improvement Committee which again includes harm patient experience. The annual quality plan which they review first recommend to the board. The board will review it, discuss it,</p> <p>00;10;59;21 - 00;11;31;11<br> Harry S. Smith<br> at times we tweak it. That will become the annual plan of quality for our system. They look at falls, wrong site surgeries, lab issues, patient access, wound care. All of this happens on a monthly basis. You couldn't expect a board of 14 to 16 to really have that depth and level of knowledge to review every month, the thousands of hours that go into the details to come to that committee on a monthly basis, which typically meets for two to 2.5 hours.</p> <p>00;11;31;14 - 00;11;40;23<br> Harry S. Smith<br> So they have figured out how to get this information. And what underlies that information is a tremendous amount of detail.</p> <p>00;11;40;25 - 00;12;08;18<br> Chris DeRienzo, M.D.<br> Thank you for tuning in to this episode of Safety Speaks, the podcast series dedicated to patient safety, brought to you by the ���������� Association. I'm Dr. Chris DeRienzo, the AHA’s chief physician executive and a champion of the AHA Patient Safety Initiative. AHA’s Patient Safety Initiative is a collaborative, data driven effort that lifts up the voices of individual hospitals and health systems into the national patient safety conversation.</p> <p>00;12;08;21 - 00;12;40;18<br> Chris DeRienzo, M.D.<br> We strive to catalyze and connect health care professionals like you across America in your efforts to innovate and improve, and to bolster public trust in hospitals and health systems by helping you share your successes. For more information and to join the 1500 other hospitals already involved, visit aha.org/patientsafety or click on the link in the podcast description. Stay tuned to hear more about the incredible work of members of the AHA's Patient Safety Initiative.</p> <p>00;12;40;20 - 00;12;47;13<br> Chris DeRienzo, M.D.<br> Remember, together, we can make health care safer for everyone.</p> <p>00;12;47;15 - 00;12;56;00<br> Sue Ellen Wagner<br> So that QMAC is a way to keep quality at that local community hospital level, and then weave it right up to the top to the system.</p> <p>00;12;56;06 - 00;13;29;09<br> Harry S. Smith<br> Absolutely. I'm not sure I'll say it's our challenge, but our opportunity now and this has been a ten year endeavor. But QMAC really in the last four years has come of its own to where the data, the conversation, the presentation, that's all very, very good. We still have some pockets though, where we could have better standardization of delivery of quality throughout our various entities, including our employed physicians.</p> <p>00;13;29;11 - 00;14;02;12<br> Harry S. Smith<br> That's really the drive right now. We started in 2017 on a journey called High Reliability Organization, which is comprehensive, expensive in the short run, but will be very beneficial in the long run. And it's a journey that never ends. I think I've mentioned to you before, this really came from the Navy. And what does that mean? It means what happens 100% of the time should happen, and what shouldn't happen 100% of the time doesn't happen.</p> <p>00;14;02;14 - 00;14;24;12<br> Harry S. Smith<br> And that's not easy to do. But if that is your goal, if that is your mission, if you know that you want to do everything right. If you don't, you correct it, you learn from it, and then you have to have those standards across the system that everybody is operating in the same manner. And that's where we're finding still a little bit of some variables.</p> <p>00;14;24;15 - 00;14;49;26<br> Harry S. Smith<br> The last thing they look at, and the most important thing that QMAC back presents to our board then would be our dashboard, our KPIs. This is approved. Our quality plan annually originates from this committee representing all of those constituents I mentioned earlier. Comes up to the board and is presented twice. Once - okay, here's what we think. You all chew on this for a month or two.</p> <p>00;14;49;27 - 00;15;14;26<br> Harry S. Smith<br> We're going to come back and then receive formal board approval for our quality plan. In the last three years, the board has made a few tweaks. They never have just blindly accepted the QMAC report and quality plan. An example would be the mortality index. We were doing really, really very well on that. Because we were doing so well</p> <p>00;15;14;28 - 00;15;33;22<br> Harry S. Smith<br> QMAC folks in executive management recommended, because the hurdle was already pretty high, that we should continue that for the next year. Board members said, we think you need to raise that. You've already obtained this level. And they go, yeah, but this is a great level when you look at peer. Yeah, but we think you can do better.</p> <p>00;15;33;25 - 00;15;35;06<br> Harry S. Smith<br> And they exceeded that.</p> <p>00;15;35;11 - 00;15;37;11<br> Sue Ellen Wagner<br> Commend you for that. That's amazing.</p> <p>00;15;37;14 - 00;15;58;23<br> Harry S. Smith<br> Thank you. And they did accept us. So currently we are looking at and this is where we had to tweak the mortality index. We look at whole house infection. We used to just look at sepsis. They made the change. I asked our quality medical officer, tell me what this whole house infection is. And he goes, well it's a new indices that CMS is looking at.</p> <p>00;15;58;25 - 00;16;21;07<br> Harry S. Smith<br> And sepsis. We've got a pretty good handle on that in our system now. So we're now looking across the whole system i.e. the whole house at all infections not just sepsis. If we would see sepsis crop up, then we certainly would put a shining light on that and give that more attention. We are looking average length of stay.</p> <p>00;16;21;08 - 00;16;48;04<br> Harry S. Smith<br> We think that is important, which ties a little bit into and we still have operating margin. And then last is engagement. Employee, outpatient, inpatient, ED - critically important to us. What people think about us, how do they feel about our quality. And we take that seriously. These are our major dashboard KPIs. And really only 20% of that is finance.</p> <p>00;16;48;06 - 00;16;59;23<br> Harry S. Smith<br> You might say a little bit of length of stay is tied to finance. And I will tell you, a decade ago, 60% would have been financial indicators. Now it's 20%.</p> <p>00;16;59;25 - 00;17;02;10<br> Sue Ellen Wagner<br> And the rest is quality or most of it.</p> <p>00;17;02;13 - 00;17;27;15<br> Harry S. Smith<br> Most is quality. And again, working through that socially, politically and again when you're realigning boards and duties and we're wanting to get to a point where you never will get. And that's 100% perfection. But if that's your goal and if you can continue to improve on that goal, tweak it as you get there, then I think we've done our job. </p> <p>00;17;27;17 - 00;17;47;15<br> Sue Ellen Wagner<br> Absolutely. Wow. So you've really described a great case example for other systems to follow and other hospitals. You're still keeping that quality local, but your reduced the number of meetings that boards have to go to. And that system is still seeing what's going on across all of your six hospitals. That's great.</p> <p>00;17;47;17 - 00;18;12;27<br> Harry S. Smith<br> We are. We have independent trustees. The chair of QMAC has to be a trustee. Now we're lucky this happens to be a physician. So that's great. We have a trustee who is a nurse, actually dean of a nursing school who had been a practicing nurse. She is on that. So we have independent nursing validation. We then have several independent trustees who do not have a medical background.</p> <p>00;18;13;00 - 00;18;33;08<br> Harry S. Smith<br> And we now require that members of the board who are not members of QMAC mandatorily have to attend at least one meeting a year. Because in one of our surveys a couple of years ago, members said they weren't sure that we were meeting our quality commitment. Those on the committee were going, what?</p> <p>00;18;33;10 - 00;18;37;05<br> Sue Ellen Wagner<br> So you just weren't transferring the information more broadly.</p> <p>00;18;37;08 - 00;19;13;20<br> Harry S. Smith<br> And we were bringing it up to the system board, but we were bringing it up through, you know, a monthly meeting report, but some probably weren't going to that S-bar or reviewing those 100 or so pages. Nor should they. They were newer learning how to trust this. Is it really working as we think it should? One way to get that is to have the experience of attending that meeting at least once during the year, to really see what these very dedicated professionals are committing to and doing, to continue to strive to improve quality, to again that 100% level.</p> <p>00;19;13;22 - 00;19;37;27<br> Sue Ellen Wagner<br> It's a very important step to make sure that all your board members are knowledgeable about what's going on and understand. And I also think it's pretty phenomenal that you've modified the way your consent agenda is done, and you're talking more about quality. We talked earlier at the AHA Annual Meeting at our Age Friendly and Quality and Patient Safety program, how it's so important to have quality be front and center of your board members.</p> <p>00;19;38;00 - 00;19;52;06<br> Sue Ellen Wagner<br> Any other words of wisdom for other boards in terms of what they should be focusing on, on quality and patient safety, or how they get buy in to make some changes to their board structure and how they should be talking about quality and patient safety.</p> <p>00;19;52;08 - 00;20;19;27<br> Harry S. Smith<br> I think the first is don't be shy that you don't know everything. You may not have a background in health care. That's where I think most of the apprehension might be. You have to be comfortable in giving up the perceived local control. You have to develop what your community, what your structure that will work for you and it.</p> <p>00;20;19;29 - 00;20;49;01<br> Harry S. Smith<br> And I would say this would be more for those trustees that don't have that quality level of background. It's okay to ask a question. I mean, I'm a banker and I've started this years ago going, how many meetings do you attend and why are we spending so much time on this and why are we doing that? Getting involved in organizations like the ���������� Association, attending meetings, listening to peers best practices.</p> <p>00;20;49;03 - 00;21;14;08<br> Harry S. Smith<br> It really does help with efficiency, effectiveness. And it's okay to ask that question. It might not work for everyone. That's okay, but you can improve what you're doing in every single instance and circumstance in every part of this country if you just aren't comfortable with the status quo and just ask why, how, and maybe we can do things better, we found that you can.</p> <p>00;21;14;10 - 00;21;19;06<br> Sue Ellen Wagner<br> Well, I think you've provided some great insights for our listeners, and I want to thank you for joining me.</p> <p>00;21;19;13 - 00;21;20;24<br> Harry S. Smith<br> Thank you, Sue Ellen.</p> <p>00;21;20;26 - 00;21;29;05<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Wed, 03 Jul 2024 16:56:02 -0500 Governance Effectiveness /news/perspective/2024-05-17-supporting-hospital-and-health-system-boards-we-navigate-changing-health-care-landscape <p>The many complexities of health care today continue to challenge hospital and health system governing boards to ensure that high-quality patient care is provided to the communities they serve.</p><p>Nowadays, boards need to bring much more than traditional oversight of finances, quality and patient care. Board members must be knowledgeable across a wide variety of health care topics and issues (some further their learning by rounding with clinicians), as well as community bridge-builders who can forge coalitions to advance health.</p><p>The past few years have wrought profound changes, expanding the board’s role in hospital and health system oversight as never before.</p><p>For one thing, the accountability of boards has substantially increased. Today, board members find themselves confronted with multi-faceted challenges such as workforce shortages, a rise in behavioral and mental health issues that impact their communities and workforce, not to mention the ever-present threat of cyberattacks and the expanding role of artificial intelligence.</p><p>Successfully engaging with these issues requires not only a thorough understanding of them, but the ability to create workable strategies and solutions to support their hospitals and health systems to continue to provide high-quality care for their patients and communities.</p><p>Today’s risks have become more significant than in the past. For example, it is important for hospitals and health systems to have a cybersecurity plan in place and for boards to understand what the plan is, what the risks are and what the plan will be going forward.</p><p>And because risk oversight has become increasingly important to organizational sustainability, boards also need to create an enterprise risk management (ERM) discipline that supports the identification, assessment and management of risks. This helps boards to function as effective stewards and fiduciaries and focus on the issues critical to creating greater value for their organizations and stakeholders.</p><p>At the same time, boards also should be looking at their structure to ensure they are diverse in representing their community’s needs. Diversity not only means race and ethnicity, but age, expertise and skill set. A diverse board is a strong board, one that can have robust discussion about the issues impacting their hospitals and health systems.</p><p>Service as a board member today can be demanding, but the opportunity to guide, advise and support the health care organizations that are cornerstones of our communities is immensely rewarding.</p><p><strong>The AHA supports good governance by offering education and resources on governance practices and our field’s emerging challenges that are crucial to advancing health in every community across the country. </strong><a href="https://trustees.aha.org/" target="_blank" title="AHA Trustee Services homepage"><strong>AHA’s Trustee Services</strong></a><strong> serves as the hub for a broad array of efforts to help hospitals and their boards navigate the transforming health care landscape.</strong></p><p>In addition, several of AHA’s key meetings have sessions or educational tracks designed for trustees. For example, at July’s <a href="https://leadershipsummit.aha.org/" target="_blank" title="2024 AHA Leadership Summit homepage">AHA Leadership Summit</a> in San Diego, trustees will have opportunities to enhance their understanding of emerging issues in governance and learn to apply new models and practices.</p><p>Good governance helps ensure quality care for patients and families; fosters safe, positive environments for health care teams; and ultimately helps create healthier communities.</p><p>Thanks to all the community leaders who serve on hospital and health system boards across the country. Please use our <a href="https://trustees.aha.org/" target="_blank" title="AHA Trustee Services homepage">trustee resources</a> as additional insight and tools so we can continue our work together to advance health in America.</p> Fri, 17 May 2024 08:38:03 -0500 Governance Effectiveness /2024-05-10-helping-boards-help-rural-hospitals <p>The constant strain of workforce and financial issues are proving difficult to solve for rural health care providers. In this conversation, Barbara Sowada, president of the Board of Trustees at Memorial Hospital, discusses the role board members can play in helping their hospitals and health systems navigate today’s pressing problems, and how the AHA’s resources and educational materials can provide valuable assistance.</p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00;00;00;28 - 00;00;27;14<br> Tom Haederle<br> Ask any hospital leader to name the biggest challenges facing their organization, and their answers are pretty much the same, regardless of size. But for rural care providers, the workforce and financial issues found everywhere are harder to solve, and they're looking to their boards of trustees for help. </p> <p> 00;00;27;17 - 00;00;49;21<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA communications. Join us for this brief but on-point discussion of the role board members can play in helping their hospitals and health systems navigate today's pressing problems, and how the AHA's resources and educational materials can assist board members in turn. </p> <p> 00;00;49;23 - 00;01;12;28<br> Sue-Ellen Wagner<br> I'm Sue Ellen Wagner, vice president of trustee engagement and strategy for the ���������� Association. I'm here at the AHA Rural Conference in Orlando, Florida with Barbara Sowada, who's the president of the board of trustees for Memorial Hospital of Sweetwater County in Rock Springs, Wyoming. Barbara, thank you for joining me today. </p> <p> 00;01;13;00 - 00;01;16;14<br> Barbara Sowada, Ph.D.<br> Thank you for inviting me. It's a pleasure to be here. </p> <p> 00;01;16;16 - 00;01;23;02<br> Sue-Ellen Wagner<br> Barbara, can you highlight the top three challenges that rural hospital boards are experiencing? </p> <p> 00;01;23;05 - 00;01;58;16<br> Barbara Sowada, Ph.D.<br> Obviously, workforce stability, including physician recruitment. That is difficult in rural areas. The financial challenges Medicare and Medicaid do not cover the cost of care right now. And then the commercials are, what should I say,  providing their own challenges with pre-authorization and denials. The other part with the commercials is we're just starting to experience in Wyoming narrow networks through Medicare Advantage. </p> <p> 00;01;58;18 - 00;02;18;00<br> Sue-Ellen Wagner<br> Thank you for citing those challenges that we've heard at the conference a lot about the financial and the workforce challenges. So given the challenges that you just talked about, rural hospitals do serve a tremendous value to their communities, and trustees represent these communities. So can you expand a little bit more on that? </p> <p> 00;02;18;02 - 00;02;49;06<br> Barbara Sowada, Ph.D.<br> Yeah, the challenges, as you know, the no mission, no margin or no margin, no mission. One of the tricks anymore is to find that balance between what is affordable and what are the community's needs. One of the things that I forgot to mention, but is a challenge nationwide, is behavioral health. And again, in rural areas that I don't know whether it's worse in some areas of the country </p> <p> 00;02;49;06 - 00;02;57;03<br> Barbara Sowada, Ph.D.<br> yes, mental health is more challenging than in the urban areas. And again, it's a dearth of resources. </p> <p> 00;02;57;05 - 00;03;15;00<br> Sue-Ellen Wagner<br> Absolutely. Yeah. We hear a lot about the behavioral health challenges. My colleague Rebecca Chickey spearheads the behavioral health issues for AHA And we do a lot of collaboration with her. So what can AHA trustee services do to help boards, specifically the rural boards? </p> <p> 00;03;15;02 - 00;03;46;01<br> Barbara Sowada, Ph.D.<br> I think the things that you are doing right now, the continuing education...the newsletters...you have a fabulous webinar archival board, the education is fabulous. What was really fun today, is one of the AHA - and I cannot remember her name - employees is working with our hospital to become critical access. So your resources are widespread and greatly appreciated. </p> <p> 00;03;46;07 - 00;04;11;11<br> Sue-Ellen Wagner<br> Oh that's good to hear. We aim to help our members. Our website is trustees with an "S" trustees.aha.org. As Barbara mentioned, we do have a wealth of information, including some boardroom briefs, which are 2 or 3 pagers, which also includes some questions that board members can ask about specific issues. We do have a brief on behavioral health, so I encourage folks to listen to that. </p> <p> 00;04;11;14 - 00;04;25;27<br> Sue-Ellen Wagner<br> As Barbara mentioned, we do have some great recorded webinars on quality and some other issues. Anything else you want to talk about, Barbara? Maybe something at the rural conference that you learned about or heard about that could be helpful to our listeners? </p> <p> 00;04;25;29 - 00;05;01;19<br> Barbara Sowada, Ph.D.<br> One of the things that really delighted me and surprised me are there are several presentations on, I would say, building relationships, having more civil conversations, the need to repair community relationships, sometimes even relationships within an organization. That is part of the focus of this week's conference is truly delightful, and I actually encourage you to do more of that, whether it's written or webinars or what have you, because that communication is just key. </p> <p> 00;05;01;22 - 00;05;11;09<br> Sue-Ellen Wagner<br> Well, for folks who weren't able to join us at the conference, hopefully they'll visit our website and utilize some of our podcast and webinars. Thank you for being with us today, Barbara. </p> <p> 00;05;11;11 - 00;05;15;09<br> Barbara Sowada, Ph.D.<br> Oh, thank you, Sue Ellen. This is delightful and I love the conference. </p> <p> 00;05;15;12 - 00;05;17;24<br> Sue-Ellen Wagner<br> Great. Thank you. </p> <p> 00;05;17;26 - 00;05;26;06<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Fri, 10 May 2024 00:43:51 -0500 Governance Effectiveness /sustainability/health-care-leaders-guide <div></div><div> #main-content p, #main-content ol>li, #main-content ul>li{ font-size:16px } </div> .Banner_Title_Overlay_Bar { position: relative; display: block; overflow: hidden; max-width: 1170px; margin: 0px auto 0px auto; } .LogoInsert { position: absolute; top: 0px; height:100%; left:0px; } .LogoInsert img{ max-width:500px; max-height:125px; top:calc(50% - 125px/2); left:calc(100% + 50px); position:absolute; } .LogoInsert h1{ position:absolute; left:0px; bottom:0px; width:500px; opacity:0; margin: 0px; padding: 0; } @media (max-width:640px) { .LogoBG { object-fit: cover; height: 200px; } .LogoInsert img { max-width: 250px; left: calc(100% + 15px); top: calc(50% - 112px/2); background-color: #00584499; padding: 25px; border-radius: 30px 0px; } } @media (max-width:320px) { .LogoBG { height: 150px; } } <header class="Banner_Title_Overlay_Bar"><img class="LogoBG" src="/sites/default/files/2023-03/sustainability-roadmap-web-home-banner-1170x250.jpg" alt="Banner Image - Glass Earth sitting in a hand over tall grass"><div class="LogoInsert"><img src="/sites/default/files/2023-03/SustainabilityRoadmap_Logo_Hor-white_700x217.png" alt="Sustainability Roadmap for Health Care | Achieving Your Sustainability Goals - Logo"></div></header> .shcIntro{ background-color:#78be2022; padding: 5px 50px 15px 50px; margin-bottom:20px; } .shcIntro h1, .shcIntro h2, .shcIntro h3 { color: #005844; text-align: center; } .shcIntro h1{ font-size:2em; } .shcIntro h2{ font-size:1.6em; } shcIntro ul{ color: grey; } <div class="shcIntro"><h1>The Health Care Leader’s Guide to Sustainability and Environmental Stewardship</h1><h2>Communicate Goals and Actions in Environmental Stewardship</h2></div><div class="raw-html-embed"> <div class="row"> /* TocMini */ .TocMini { margin: 0px auto 25px; padding-bottom: 5px; color: #005844; letter-spacing: 1.5px; font-weight: 400; font-size: .7em; width: 80%; } .TocMini .TocMiniBar { border: 1px solid #78be20; padding: 5px 10px; overflow: auto; border-radius: 20px 0px; } .TocMini .TocMiniBar .TocMiniGroup a:after { content: "|"; padding: 0 3px 0 6px; color: #253b80; font-weight: 700; } .TocMini .TocMiniBar .TocMiniGroup a:last-child:after { content: ""; } .TocMini .TocMiniGroup { float: right; } .TocMini .TocMiniHome { text-transform: uppercase; color: #005844; font-weight: 700; } .TocMini .TocMiniChild { font-weight: 500; opacity: .9; color: #555; } .TocMini .TocMiniHome:hover, .TocMini .TocMiniChild:hover { text-transform: ; color: #5fa1d0; } .TocMini .TocMiniActive{ font-weight: 700; color: #5fa1d0; } /* TocMini // */ <div class="TocMini"> <div class="TocMiniBar"> <a class="TocMiniHome" href="/sustainability" target="_blank" title="Home - Sustainability Roadmap for Health Care">Sustainability Roadmap for Health Care</a> <div class="TocMiniGroup"> <a class="TocMiniChild" href="https://www.ashe.org/sustainability" target="_blank" title="ASHE Sustainability for Health Care Facilities">Sustainability for Health Care Facilities</a> <a class="TocMiniChild" href="/sustainability/glossary" target="_blank" title="Glossary">Glossary</a> <a class="TocMiniChild" href="https://www.ashe.org/sustainability/healquest" target="_blank" title="HealQuest">HealQuest<sup>TM</sup></a> </div> </div> </div> </div> </div> .shcHighlight h3{ color:#005844; font-size:2em; } .shcHighlight span{ font-weight:700; color:#78be20; } <div class="row shcHighlight BulletCircle"><div class="col-sm-9"><p>In navigating the complex landscape of sustainability and environmental stewardship within the health care field, engaged, effective leadership is key. Leaders set goals, such as reducing energy consumption, waste generation and greenhouse gas emissions. In addition, leaders foster cultures of innovation and collaboration by encouraging interdisciplinary teams to explore and implement environmentally friendly solutions throughout their organizations. <em>The Health Care Leader’s Guide to Sustainability and Environmental Stewardship</em> provides a toolkit of tangible action items for CEOs, boards and trustees, sustainability teams, COOs, and CFOs, demonstrating how each can lead the charge in environmental stewardship.</p><ul><li><a href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf#page=10" target="_blank" title="Jump to: Reinforcing the Mission"><strong>Learn more about Reinforcing the Mission</strong></a></li><li><a href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf#page=7" target="_blank" title="Jump to: Why"><strong>Articulating the “Why”</strong></a></li><li><a href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf#page=17" target="_blank" title="Jump to: The Business Case"><strong>The Business Case</strong></a></li><li><a href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf#page=2" target="_blank" title="Jump to: Creating Value"><strong>Creating Value</strong></a></li><li><a href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf#page=11" target="_blank" title="Jump to: Leading toward Sustainability"><strong>Leading toward Sustainability</strong></a></li></ul><p><a class="btn btn-primary btn-wid" href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf" target="_blank" title="Download The Health Care Leader’s Guide to Sustainability and Environmental Stewardship">Download the Guide</a></p></div><div class="col-sm-3"><p><a href="/system/files/media/file/2025/03/Leaders-Guide-Environmental-Stewardship.pdf" target="_blank" title="Download the Guide: The Health Care Leader’s Guide to Sustainability and Environmental Stewardship"><img src="/sites/default/files/2025-03/Leaders-Guide-Environmental-Stewardship-600x777.jpg" alt="The Health Care Leader’s Guide to Sustainability and Environmental Stewardship" width="100%"> </a></p></div></div> Wed, 28 Feb 2024 11:00:00 -0600 Governance Effectiveness <div class="row"><div class="col-md-6"><div class="embed-responsive embed-responsive-16by9"> Your browser does not support the video tag. </div></div><div class="col-md-6"><p>Discover insights from the <a href="/patient-safety-initiative-registration" title="AHA Patient Safety Initiative Kickoff Event">AHA Patient Safety Initiative Kickoff Event</a> held virtually on Jan 29, 2024. Dive into the goals and objectives discussed by key speakers Chris DeRienzo, M.D., Akin Demehin and Marie Cleary-Fishman. Explore valuable educational offerings and collaboration opportunities that shape the future of patient safety.</p><div><p><a class="btn btn-primary btn-wide" href="/system/files/media/file/2024/01/Kickoff-Event-AHA-Patient-Safety-Initiative-2024.pptx" target="_blank" title="Slide Deck for Kickoff Event, AHA Patient Safety Initiative 2024">Download the Slide Deck</a></p></div><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title"><a href="/aha-patient-safety-initiative" title="Return to the AHA Patient Safety Initiative landing page.">Patient Safety Initiative</a></h3></div><div class="panel-body"><ul><li><a href="/patient-safety-initiative-leadership">Leadership</a></li><li><a href="/patient-safety-initiative-registration">Patient Safety Initiative</a></li><li><a href="/patient-safety-initiative-resources">Resources</a></li><li><a href="/patient-safety-initiative-faq">FAQ</a></li></ul></div></div></div></div> Thu, 01 Feb 2024 15:35:13 -0600 Governance Effectiveness /trustee-trends-2024-new-twists-familiar-challenges .bannerHero { background-image: /*linear-gradient(rgba(0, 0, 0, 0.5), rgba(0, 0, 0, 0.5)),*/ url("/sites/default/files/2024-01/trustee-trends-2024-banner-1170x250.jpg"); background-position: center; background-repeat: no-repeat; background-size: cover; position: relative; height: 1000px; max-height:250px; max-width: 100%; margin: 0 auto; overflow:hidden; text-align: center; } .bannerHero .contentBottom { position: absolute; bottom: 0; /* background-image: linear-gradient(-180deg, rgba(46,46,46,0), rgba(46,46,46,1));*/ width: 100%; /* left + right + border */ padding: 15px 50px 50px 50px; /*! border: solid 2px green; */ color: #fff; } .bannerHero .contentBottom h1{ font-size:2.8em; } .bannerHero .contentBottom p{ font-size:2em; line-height: 1.2em } @media (max-width:568px){ .bannerHero { max-height:350px; } .bannerHero .contentBottom { padding: 15px 15px 15px 15px; bottom: 50; } .bannerHero .contentBottom h1{ font-size:2.3em; } .bannerHero .contentBottom p{ font-size:1.5em; } } <div><div class="bannerHero"><div class="contentBottom"><h1>Trustee Trends in 2024: <br>New Twists to Familiar Challenges</h1></div></div></div> @media (min-width:768px) { .sp_CTA1b_holder { top: -15px; } } @media (max-width:767px) { .sp_CTA1b_holder { top: 0; /*margin: 0px 50px;*/ } } .row.sp_CTA1b { margin: 0 !important; display: flex; justify-content: center; align-items: center; } .sp_CTA1b_holder { background-color: #fff; /*! padding: 15px 0; */ position: relative; overflow: auto; border: solid 2px #307FE2; text-align: center; float: inline-start; padding: 10px 30px; } .sp_CTA1b h3 { color: #002855; font-size: 1.4em; margin: 0px; /*! 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What headwinds should board members be aware of? Issues range from the use of AI in health care spaces to health care disruptors to the implementation of the CMS Quality Assessment and Performance Improvement (QAPI) program. Some of these issues overlap: might AI be useful in managing workforce pressure? Could outreach or lack thereof to Gen Z affect a hospital’s quality metrics?</p><p class="center_Lead">This article from AHA’s Trustee Services speaks to the major trends we expect will affect hospital and health system trustees in 2024 and beyond. Each section contains Trustee Discussion Topics that can serve as a way to assess your organization’s readiness for the future. These questions can also be used by boards to serve as a starting point for these vital conversations. Trustee Services will continue this conversation as we look to the future for board members.</p></div><div class="col-sm-4 col-md-3"><img src="/sites/default/files/2024-01/trustee-trends-2024-page-1-500_0.jpg" alt="Trustee Trends 2024" width="500" height="664"> </div></div></div> .SponsorMarketoForm { background-color: ; padding:5px 25px; border: solid 2px #307FE2; margin:50px 15px 0px !important; display:inline-block; width: -webkit-fill-available; margin-bottom:25px; } .SponsorMarketoForm h3{ margin:10x 0 0 0 ; color:#9D2235; font-size:.7em; text-transform:uppercase; font-weight:400; letter-spacing:3px; max-width:200px; /* Custom for the copy length */ background-color:#fff; padding: 5px 15px; position:relative; top:-35px; height: 0px; } .SponsorMarketoForm h2{ color: #002855; } .SponsorMarketoForm .SponsorMarketoFormHolder{ background-color: ; padding:15px; display: inline-block; margin-bottom:25px; } .SponsorMarketoFormHolder form{ margin: auto; } @media (max-width:640px){ .SponsorMarketoForm { padding:5px 0px; } .SponsorMarketoForm .SponsorMarketoFormHolder{ padding:15px 0px; } } /* Marketo Over-ride */ .mktoForm .mktoFormRow:nth-child(3){ float: left; } /*Center the last row .mktoForm .mktoFormRow:nth-child(4){ margin-left:15%; } */ .mktoForm label{ font-size: 0px; width: 0px !important; } .mktoForm input{ height: 30px } .mktoForm .mktoButtonRow{ float: left; } .mktoForm .mktoButtonWrap { margin-left:20px !important; } .mktoForm .mktoButton { background-color: #307FE2 !important; border: 1px solid #307FE2 !important; color: #fff !important; padding: 0.4em 1em; font-size: 1em; background-image: none !important; min-width: 190px; margin: 0 15px; border-radius: 4px; padding: 10px 20px; transition: all .25s ease-in-out; text-shadow: none; white-space: normal; height: 30px; font-weight: 700 } .mktoForm .mktoButton:hover{ background-color: #002855 !important; border: 1px solid #002855 !important; color: #fff !important; } .mktoForm .mktoClear { clear: none; } .SponsorMarketoForm { background-color: ; padding:5px 25px; border: solid 2px #307FE2; margin:50px 15px 0px !important; display:inline-block; width: -webkit-fill-available; margin-bottom:25px; } .SponsorMarketoForm h3{ margin:10x 0 0 0 ; color:#9D2235; font-size:.7em; text-transform:uppercase; font-weight:400; letter-spacing:3px; max-width:200px; /* Custom for the copy length */ background-color:#fff; padding: 5px 15px; position:relative; top:-35px; height: 0px; } .SponsorMarketoForm h2{ color: #002855; } .SponsorMarketoForm .SponsorMarketoFormHolder{ background-color: ; padding:15px; display: inline-block; margin-bottom:25px; } .SponsorMarketoFormHolder form{ margin: auto; } @media (max-width:640px){ .SponsorMarketoForm { padding:5px 0px; } .SponsorMarketoForm .SponsorMarketoFormHolder{ padding:15px 0px; } } /* Marketo Over-ride */ .mktoForm .mktoFormRow:nth-child(3){ float: left; } /*Center the last row .mktoForm .mktoFormRow:nth-child(4){ margin-left:15%; } */ .mktoForm label{ font-size: 0px; width: 0px !important; } .mktoForm input{ height: 30px } .mktoForm .mktoButtonRow{ float: left; } .mktoForm .mktoButtonWrap { margin-left:20px !important; } .mktoForm .mktoButton { background-color: #307FE2 !important; border: 1px solid #307FE2 !important; color: #fff !important; padding: 0.4em 1em; font-size: 1em; background-image: none !important; min-width: 190px; margin: 0 15px; border-radius: 4px; padding: 10px 20px; transition: all .25s ease-in-out; text-shadow: none; white-space: normal; height: 30px; font-weight: 700 } .mktoForm .mktoButton:hover{ background-color: #002855 !important; border: 1px solid #002855 !important; color: #fff !important; } .mktoForm .mktoClear { clear: none; } <div class="row spacer" id="ahaLeadershipScan"><div><div class="col-md-10 col-md-offset-1"><div class="cta--image-container full_width SponsorMarketoForm"><h3>Trustee Trends 2024</h3><div class="col-sm-12"><h2>Download the Trustee Insights Special Edition: Trustee Trends in 2024: New Twists to Familiar Challenges</h2><div class="SponsorMarketoFormHolder">   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 3693); MktoForms2.whenReady(function(form){ if(form.getId() == 3693 ) { form.onSuccess(function(values, followUpUrl) { form.getFormElem().hide(); document.getElementById("successAndErrorMessages").innerHTML="<div><p>Thank you.<\/p><br /><p><a class='btn btn-wide btn-primary' data-view-context='top-level-view' href='\/system\/files\/media\/file\/2024\/01\/trustee-trends-2024.pdf' target='_blank' rel='noopener noreferrer nofollow'>Download Trustee Trends 2024<\/a><\/center><\/div>"; return false; }); }; }); <div id="successAndErrorMessages"> </div></div></div></div></div></div></div> Wed, 24 Jan 2024 11:26:44 -0600 Governance Effectiveness