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PubMed1991

An assessment of rural hospital trustees' health care knowledge base.

Rural hospital trustees are usually volunteers who serve important roles in the governance of a hospital and, therefore, in defining health care policy in their communities. Because most trustees are not health professionals, their orientation to the hospital and continuing education about the hospital present a special challenge to administrators. One hundred and three trustees from 10 rural hospitals in western New York were surveyed to better understand their demographics, their knowledge base regarding the hospital, and their roles as trustees. Sixty-six percent of the respondents were male and the average age of the sample was 48 years. Trustees had served an average of six years and spent seven hours per month on hospital business. Eighty-three percent recalled receiving some orientation. Answers about average hospital census, length of stay, payor type, and hospital services were correct less than 50 percent of the time. Trustees were aware that recent quality assurance guidelines increased their liability and half believed it was their most important activity. We conclude that greater effort should be applied to the orientation and continuing education of hospital trustees. Given the significant time commitment already asked of trustees, this education should be woven into the hospital governance routine.

Demography↗
PubMedDate not supplied

New accountabilities, challenges for trustees.

Trustees can no longer view their responsibilities as passive or symbolic. The health care ministry today demands trustees who can articulate their convictions to colleagues and administration. Clarifying and implementing this new role is a challenge--perhaps even a key to survival--for Catholic health care organizations in the next 10 years. Trustees hold "a charter of public trust" and therefore are accountable to three distinct but concentric constituencies: Society. Socially accountable to trustees must be financially honest, ensure competent administration, and make certain their services enhance the common and social good. Church. Trustees, in being accountable to the Church, must ensure that their organizations comply with canon law and do not violate Church teachings. Religious institute. Trustees must assist religious institutes to ensure that collaboration occurs among Catholic systems and facilities as well as with all persons of good will. From these three forces flow five crucial challenges for trustees of Catholic health care organizations: Ensure that their organization's allocations for charity care are specific and clear to maintain not-for-profit, tax-exempt status. Lower costs but ensure high-quality care. Champion issues of economic social justice, especially access to health care. Work to manifest Christ's mission in the world. Commit to collaboration with all other Catholic organizations in such a way as to serve people in the most effective manner. Seeing God as the center of these challenges can help trustees and providers to move mountains.

Catholicism↗
PubMed1989

Demystifying the boardroom. Tips for timid trustees.

The complexity of a modern hospital can mystify and intimidate trustees; they may have difficulty understanding how the hospital works and thus may feel unable to contribute to its success. Stripping away some of the mystery may enable them to more effectively fulfill their roles to "hold in trust" and "govern." Some strategies trustees can use to gain control include hiring a chief executive officer (CEO) who can communicate, remembering who works for whom, assuming that anyone who makes more than $80,000 a year expects to earn it, and stifling the urge to seek "fairness." To clarify the relationship between board and CEO, trustees should ask the following questions: Are all subsystems contributing to the system's overall goals, or are some serving their own ends? Does the system allow interaction among subsystems to promote synergy, or does it isolate the parts? How does the CEO plan to produce the required product or service and achieve profit goals within the organizational policies? How will the trustees know whether the intended product or service has been produced within the organizational policies at the desired profit? By following a code of conduct, trustees will become more effective. The seven elements of the code include observing behaviors and reporting observations, asking questions and insisting on clear answers, establishing relationships with constituencies, making decisions and being willing to explain those decisions, making sure solutions fit problems, realizing that management is a series of approximations, and seeing that adherence to the hospital's mission dominates the criteria used in free choices.

Communication↗
PubMed1979

Trustees and hospital associations: a closer bond.

Recent years have seen a noticeable expansion of trustee involvement in allied hospital association activities. Among the most active areas are more direct trustee involvement in the organization and governance of the associations, innovative trustee education programs, and wider applications of trustees' traditional work as legislative liaisons. A variety of programs are proving the benefits that can be reaped from greater trustee participation in hospital associations.

Education↗
PubMed1992

Moral responsibilities of trustees: some first thoughts.

The role of a trustee is unclear to most people, including many trustees. The author proposes a view of trustees as persons who have public responsibility for private or independent provision of a public good. This is a moral definition of trusteeship; without trusteeship a pluralist society would be in trouble. The author argues that trustees should be constrained by fiduciary duties, the common good, an interpretative responsibility, and some procedural norms.

Ethics, Institutional↗
PubMed1991

Preparing stewards for tomorrow. A healthcare system's intern program provides mentors for potential trustees.

Mentors can provide support essential to a person's advancement and growth in a new business or position. Because of the complex and rapidly changing nature of healthcare, mentors can be particularly valuable to persons interested in becoming healthcare facility trustees. Since 1987, the Sisters of Mercy Health System (SMHS), St. Louis, has implemented a comprehensive intern program for potential trustees. Each intern is assigned to a board and a board member mentor at an SMHS facility. The program lasts for two years and includes a didactic component, independent study, clinical experience, regularly scheduled meetings, and issuance of a certificate on completion. Thus far, the interns have been sisters from education, healthcare, social service, or other ministries. They must show abilities crucial for successful trustees (such as listening skills), an appreciation of and strong support for the ministry, and a willingness to commit the time and energy to the program. Mentors chosen for the program also must devote time to orientation and meetings and must assist interns in integrating mission and values into board activities. In addition, mentors help interns identify the focus of present structures and resources and their appropriateness and discuss the trustee's role and responsibilities and dynamics for quality decision making.

Catholicism↗
PubMedDate not supplied

Elected or appointed? The case for healthcare trustees.

Although most trustees in Canada are appointed, there is a growing trend to publicly elect them instead. Though motivated by a desire to make healthcare boards more accountable to the public, there is no evidence that public elections will accomplish this. There are a number of mechanisms already in place to ensure accountability, and appointing trustees makes it more likely that only properly qualified trustees will hold board positions. That control is vital to ensure that trustees have the strategic business thinking necessary to ensure the future of hospital corporations.

Canada↗
PubMedDate not supplied

Orienting new trustees to their role.

Since trustees come from various backgrounds, their learning needs reflect both diversity and commonality. Those from the business sector, for example, may be adept at interpreting financial statements yet unable to assess the physician credentialing process. All new trustees, of course, need to become acquainted with the Church's role in health care, the sponsoring group's mission, and current ethical and legal issues in health care. In an actual educational needs assessment for board members with one to three years' service, the need for education was identified in such areas as program planning, quality of care assessment, personnel policies, selection and evaluation of administrators, and third-party payment methods. The administrator, as well as the sponsoring group and the board itself, should encourage new trustees to identify their learning needs and suggest activities to meet those needs. Group discussion, role playing, case studies, and the critical incident approach can be useful in encouraging the learner's active participation. Throughout the educational process, trustees should share responsibility for defining learning goals and for planning, conducting, and evaluating learning activities.

Catholicism↗