Changing perspectives on hospital governance

In the light of fundamental changes in the delivery of health and social services in Canada, hospital governance must be concerned with protection and enhancement of the organization on behalf of the owner (i.e., taxpayer) as well as accountability to the community it was established to serve. Based on a review of current literature, the authors suggest that the roles and responsibilities of a hospital board entail seven major activities: establish the mission, philosophy and future directions of the institution; choose and evaluate the chief executive officer; establish the ethical principles for the organization; ensure high quality care and services; attract resources to the institution and ensure their effective use; integrate the organization with its environment; and undertake its own self-evaluation, education and development. To play these roles effectively, hospital boards will need to develop more direct links with their communities and learn to share decision making with them.