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Don Seymour & Associates Case Studies |
Focusing on Imperatives for Success
At a Community Hospital
Client Profile: Full service 200-bed community hospital in a highly competitive Northeastern suburban market.
Project Type: Comprehensive strategic planning engagement with strong process component involving trustees and approximately 125 physicians.
Challenges: Assist the board and management in separating strategic issues from tactics and operations, while keeping the board focused at an appropriate, governance level. Educate the board regarding the importance of meeting identified community need for additional physicians versus catering to the self interest of physicians opposing recruitment.
Don Seymour & Associates Solutions and Results: DS&A facilitated the development of a strategic plan including: development of a clinical plan including five service line priorities and the resources required to support them; the need for a $250 million replacement hospital; an approach to recruiting 100 new/replacement physicians over a 10 year period; and identification of sources and uses of capital to support strategic initiatives while maintaining a strong balance sheet and meeting routine capital needs.
The plan was endorsed by the Medical Executive Committee and greeted with acclaim by the Board of Trustees, which was composed of some "tough graders" including senior executives from major corporations, the managing partner of an international management consulting firm, a professor from a well-known graduate school of business and a professor of health policy.
Restructuring Hospital Board
to Improve Effectiveness
Client profile: A respected, community teaching hospital with ties to a major academic medical center and a reputation for clinical excellence.
Project type: Board self assessment coordinated by the governance committee
Challenge: Initially, to help the parent board, frustrated by what it perceives as its own lackluster performance, to manage two competing factions within the board and governance committee in order to find enough common ground for continued discussions.
Later, to assist trustees in understanding that a "less is more" approach (stepping back from operations and management work and redefining governance work) would actually lead to more effective trusteeship.
Don Seymour & Associates Solutions and Results: DS&A conducted extensive interviews with individual trustees from the parent, hospital and foundation boards; senior executives at the hospital and foundation level and the trustees of two legacy organizations (which controlled two separate, large endowment funds).
The results of the interviews were presented to the steering group and used as the basis to identify key hurdles and to "call the question." Three meetings of the steering group resulted in consensus on the issues, potential options for addressing them and recommended solutions.
It was agreed that the board would be reduced in size through attrition. Appropriate term limits were established; the committee structure was revised with an emphasis on board work (a charge was developed for each committee); interlocking relationships were established among the parent and other boards and consistency was established in the bylaws among all corporations.
In addition, the frequency of meetings was reduced; the consent agenda (which already existed in theory) was reactivated and job descriptions for board officers were developed.
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