Transforming hospital board meetings: guidelines for comprehensive change

Does the following remind you of a hospital board meeting you attended recently? The meeting starts late, the PowerPoint presentation on hospital operations is too detailed to understand, 20 minutes are spent discussing parking, one or two trustees do all the talking, others check their PDAs or scribble on the agenda, and you try to keep your mouth shut while yawning. Hospital board meetings are often described as ritualized, unfocused, rambling, mindless, and inconclusive. Experts agree that board meetings in many hospitals are dysfunctional and need restructuring (Knecht 2001; Perrine 2003; Orlikoff and Totten 2002). Recently, St. Joseph Hospital in Orange, California, employed consultants and invested much effort in making its board meetings productive (Perrine). More such endeavors are needed for better hospital governance. In the last 5 years, several books and articles have focused on reforming board meetings. In this article I draw on them to discuss key problems of board meetings and how to make the meetings more effective.