Governing boards and profound organizational change in hospitals

Supervisory board process: Evidence from French public hospitals

We mobilize theories of corporate governance and the theory of the social psychology of decision-making small groups to understand the operational process of the public hospital supervisory board. More precisely, we empirically test the mediation relationship of the decision-making process (effort norms, use of knowledge and skills, and conflict cognitive) between its structure (size, the composition, and diversity) and the performance of its roles (strategy, control, and service). A total of 320 questionnaires coming from members of the French public hospital supervisory board were collected. The aggregation of these individual answers generates a sample of 159 public hospital supervisory boards. The results of the tests of the assumptions of the research model confirm the fact that the structure of the supervisory board does not influence the performance of its roles. However, supervisory board effort norms positively affect the performance of its roles positively. Only effort norms and the use of knowledge and the skills partially play the role of mediator between the supervisory board structure and the performance of its roles. Practical and theoretical implications are exposed in the discussion.

Defining the functions of public health governance

We conducted a literature review in 2011 to determine if accepted governance functions continue to reflect the role of public health governing entities. Reviewing literature and other source documents, as well as consulting with practitioners, resulted in an iterative process that identified 6 functions of public health governance and established definitions for each of these: policy development; resource stewardship; continuous improvement; partner engagement; legal authority; and oversight of a health department. These functions provided context for the role of governing entities in public health practice and aligned well with existing public health accreditation standards. Public health systems research can build from this work in future explorations of the contributions of governance to health department performance.

Does governance matter? Board configuration and performance in not-for-profit hospitals

As performance accountabilities, external oversight, and market competition among not-for-profit (NFP) hospitals have grown, governing boards have been given a more central leadership role. This article examines these boards' effectiveness, particularly how their configuration influenced a range of performance outcomes in NFP community hospitals. Results indicate that hospitals governed by boards using a corporate governance model, versus hospitals governed by philanthropic-style boards, were likely to be more efficient and have more admissions and a larger share of the local market. Occupancy and cash flow were generally unrelated to hospitals' governing board configuration. However, effects of governance configuration were more pronounced in freestanding and public NFP hospitals compared with system-affiliated and private NFP hospitals, respectively.

Volunteer governance of health services in Canada: redundant or relevant?

With the continued growth in size and complexity of healthcare organizations, trustes/directors are increasingly called upon to provide strategic leadership. In response, new recruitment methods have been adopted in order to meet the need for skilled and knowledgeable trustees. Volunteer governance models need to be carefully evaluated in comparison to government control models in order to determine how relations of accountability and responsibility change with a shift in models. The central question is whether volunteer governance remains a viable concept in Canada.

Identifying indicators of laboratory management performance: a multiple constituency approach

The challenges for laboratory management posed by cost control, managed care, organizational restructuring, information networking and health system integration call for new measures to evaluate how effectively laboratories manage emerging performance expectations. This study identifies the Delphi panel method in achieving consensus on measures of effectiveness and considers a specific application, the identification of indicators of laboratory performance, from the perspective of key constituencies.