Governance Trends for 2014

I read a great article this AM about what the board governance trends are for health systems in 2014 by Michael Peregrine of McDermott, Will & Emery.  Michael's trends and how each are being addressed at WMHS are as follows:

• Standard of Care - the board's role is ever increasing in this area to ensure that it is aware of its duties and that they are being executed appropriately.  A great deal of emphasis was placed on this trend through our recent board assessment results during our last board retreat.
• Level of Engagement - As complexity increases and challenges grow, boards will be asked to step up their engagement on the board.  Our board has recognized this challenge since the planning for the new hospital started and it has continued for the last three plus years under TPR.
• Strategic Planning - Special attention will be expected based on all of the challenges facing health care.  Our board approved the WMHS three-year strategic plan in late March 2014.  Development of the plan occurred under the auspices of the board's Planning Committee.
• Board Composition - Needed competencies to meet the challenges will be the focus of boards this year and into the future.  Such competencies have been a continual focus of our board's Governance Committee.
• Compliance Oversight - The Tuomey whistleblower decision, the vagaries of the Stark Law, RACs, and anti-fraud enforcement will combine to bring increased compliance oversight.  Compliance with these areas occurs through the board's Audit and Compliance Committee.
• Risk Reporting - Boards expect to be informed when substantial risk to the organization occurs.  A key responsibility of executive management at WMHS.
• Governance Structure - Emphasis will be on board size, composition, reporting relationships, and committee structure and composition, along with reporting relationships. An ongoing focus of the board Governance Committee.
• Heightened Involvement - Any issues critical to the success of the organization, such as risk, reputation, quality, care delivery and financial performance need to be shared with the board.  Executive management needs to manage each but the board needs to be "in the know."  The board is routinely kept informed when a critical issue occurs at WMHS.
• Conflict Awareness - The board needs to be sensitive to all types of potential conflicts of interest on the part of the board beyond the traditional financial relationships.  The board very throughly assesses such conflicts and they are addressed by the Executive Committee of the board.
• The Role of General Counsel - This role has evolved to guardian of the organization's legal and reputational profiles as well as a partner to management as hospitals pursue new and different business lines.  General counsel has been engaged in these areas for sometime at WMHS and has been effective at each.

In closing, having such a list of trends is very helpful and it serves as a great source of verification of just how well our board is performing its fiduciary duties at WMHS.