Question

Discuss the governance of a modern hospital. Discuss some the roles/responsibilities of the groups governing the hospital.

Answer 1

Governance of a modern hospital has traditionally followed a tripartite structure. The three major sources ofauthority in hospital governance are the CEO, the board of trustees, and the hospital’s medicalstaff. Over time, power dominance has shifted from the trustees to the physicians, and, morerecently, to the administrators. The CEO or president of a hospital is responsible for the day-to-day operations and for accomplishing the mission and objectives of the organization. The board of trustees are responsible for defining the mission and long term direction of the hospital.

Roles of the groups governing the hospital were to establish policies, to make significant and strategic decisions, and to oversee the organization's activity.

Policy making

Policies define focus and differentiate responsibilities among the board, the management, and the medical staff. Well-written policies lead to more efficient board functioning.

Decision Making

Decision making involves making choices about the organization's vision, mission, and strategies. Boards make decisions about issues that are strategic and significant, such as whether to enter an affiliation agreement with another organization.

Oversight

Oversight is an important function, but boards must remember that the organization is theirs to oversee, not to manage. Some boards cross the line and try to involve themselves in management. Nevertheless, in the oversight role, the board is legally responsible for everything that happens within the hospital, whether in the emergency department, a clinic, or a nursing unit.

Responsibilities of the groups were they oversee the management, finances, and quality, set strategic direction,build community relationships,establish ethical standards, values, and compliance, and select a CEO and monitor his or her progress.

Although the management team develops the strategic plan, it is the board's responsibility to accept or modify the strategic plan and to set the direction. The board considers elements in the environment such as growing competition and changing patterns of care and develops a vision, a mission, strategic thrusts, goals, and tactics that respond to the environment, all the while showing the organization's values.