Thought of the Day – On Fundamental Values
Category Archives: Values
10 signs your board has a strong pulse
Great systems are usually governed by great boards, who are made up of people who match the following 10 descriptions.
Great board members do more than comply with corporate governance structure and rules. Too often, board members have loose ties to one another, are passive to the wants and views of the CEO or are not as informed about the specifics of healthcare as they ought to be. We view all of these traits, and more, as signs that a board has lost its charge and is no longer effectively governing.
We consider the following 10 items as descriptors of a board member who has a strong pulse and adds value to a governing body.
1. The board member is active, engaged and passionate about being a board member. No board can afford to have disengaged members. Bylaws and attendance requirements are important, but simply complying with them does not necessarily equate to being an active, contributing and passionate trustee. Engaged board members show up to meetings, and they show up prepared. While members typically refrain from meddling in day-to-day operations, boards with high levels of trust and candor make a point to communicate with the CEO outside of scheduled board meetings. Quality of board engagement is an important contributing factor to board performance, and there is a correlation between board engagement and the ability to attract board members. Everything that follows is dependent on board engagement.
2. The board member has a point of view on what the organization must be great at, and the board member is vehement about it. Health systems cannot be all things to all people, although the opportunities to attempt this are ample. The best organizations are not static, but disciplined. Well-governed systems know the specialties they are great in, and they continue to double down on their strengths. Their boards are cognizant of where revenues come from and ensure resources are allocated accordingly.
3. The board member realizes that her top job is to ensure the system has great leadership in place. Leaders can fall short in all sorts of ways, some more visible and easily detectable than others. The active, engaged and vehement board does not easily accept disappointment. Boards have many steps at their disposal to manage a problem before firing a CEO or senior leader, but they should never function in a way where termination is unthinkable. Boards cause great damage when they tolerate mediocre performance or compromised values among people at the top of the organization.
4. The board member understands accountability for patient safety and quality of care rests firmly in the boardroom. It rests on board members to insist that they receive sufficient, timely information about patient safety and care quality from the CEO. It rests on board leadership to ensure members have access to expertise and resources to properly obtain, process and interpret this information. It is not a bad idea for quality expertise to be included in board members’ competency profiles and for boards to undergo training and continued education in quality and safety. This is especially relevant for board members who come from industries outside of healthcare. It rests on the board when care quality declines or when lapses in patient safety are unaddressed: It is unacceptable for a board to say it missed the memo on care outcomes or that it did not understand the information in front of it.
5. The board member is a watchdog on societal, governance and audit issues. Informed citizens make for strong board members. It is important to not only be plugged in and aware of the issues and challenges confronting the organization today, but to be aware of broader societal issues that could affect system strategy and performance tomorrow. This is not hypothetical thinking. The past year was a master class in how broader issues affected healthcare in acute and direct ways: systemic racism, a global supply chain and a churning labor market are just three. Good boards are made up of members who stay informed and are biased toward anticipatory thinking, in which they are eager to explore the ways in which issues larger than or outside of their industry may come to affect the organization they help govern.
6. The board member supports the leadership team, but also questions it and holds it accountable. Board members cannot be pushovers for leadership. Directors are nominated by existing board directors on the nominating committee, which often includes the CEO. As a result, trustees can empathize with the CEO of the organization on whose board they sit. Empathy does not equate to blind acceptance, but this is nonetheless a dynamic trustees should be aware of and work to keep in check. It is not unusual for board members to struggle when giving candid feedback to the CEO, for example. As a result, chief executives carry on and live in a bigger and bigger bubble.
It’s worth noting that the reverse can occur within boardrooms as well, in which board members disagree about strategy and seek a CEO they can easily influence. At the end of the day, being a pushover is not associated with strong leadership and should be avoided by both trustees and senior executives. Instead, trustees need to embrace constructive tension in the boardroom. Questions, challenges and disagreements that reach resolution can drive valuable dialogue and stronger outcomes.
7. The board member allows others to voice their thoughts. In many boardrooms, a small number of the participants do most of the talking while the majority stays relatively quiet. A powerful or well-connected member may dominate discussions. Ideally, boards embrace the middle in interpersonal communication, with trustees contributing not too much nor too little. Either goes against the board’s very reason for being.
8. The board member helps ensure the board as a whole reflects the racial, ethnic, gender, religious and socioeconomic diversity of the community served by the organization. This is important for a number of reasons, with health equity being principal. Trustees are stewards for the communities they serve. For hospitals and health systems to increase opportunities for everyone to be healthier — including those who face the greatest obstacles — they need visions, strategies and goals that begin at the top from individuals who have viewpoints from the community. Without these insights, the board simply can’t govern effectively. Additionally, research has consistently found that teams of people who have diversity in knowledge and perspectives — as well as in age, gender and race — can be more creative and better avoid groupthink.
9. The board member is accessible. Just as no board wants its CEO in a bubble, governing bodies must actively resist this risk. For a stretch of time, boards were less visible groups of people who would meet four to six times a year in a mahogany-paneled room to decide the future of an organization that employs tens of thousands and serves even more. This dynamic cannot hold in healthcare. Community members and employees should know — or be able to easily learn — who serves on their health system’s board. If stakeholders bring issues or concerns to a board member, the trustee should be prepared to respond and follow up. In 2021’s healthcare, board members cannot breathe rarified air.
10. The board member emulates the values of the health system. So often when people talk about the tone being set at the top, they have the CEO in mind. The board is just as responsible, if not more responsible, for this charge. What a board permits, it promotes. Board members that emulate system values are better positioned to collaborate with mutual respect, candor and trust. Board members whose values are mismatched or personal agendas are at cross-purposes with the good of the organization should be replaced.
Thought of the Day: On Truth and Courage
Today marks the 63rd anniversary of Harper Lee‘s “To Kill a Mockingbird” (1960) — a novel containing truths so universal that they bear repeating in 2023.
“You never really understand a person until you consider things from his point of view … Until you climb inside of his skin and walk around in it.”
“I wanted you to see what real courage is … It’s when you know you’re licked before you begin but you begin anyway and you see it through no matter what. You rarely win, but sometimes you do.”
“People generally see what they look for, and hear what they listen for.”
“The one thing that doesn’t abide by majority rule is a person’s conscience.”
“Sometimes the Bible in the hand of one man is worse than a whisky bottle in the hand of another … There are just some kind of men who — who’re so busy worrying about the next world they’ve never learned to live in this one, and you can look down the street and see the results.”
Thought of the Day: On Loyalty
4 health systems retaining talent with perks beyond pay
As hospitals and health systems continue to grapple with staffing shortages, employers are using perks beyond pay to recruit and retain talent.
Incentives beyond the norm are attractive to employees: They prove the employer values them personally, beyond their work performance.
These four health systems offer perks beyond pay, like extra paid time off, well-being coaches, adoption assistance and local discounts.
Food, entertainment and staycations
Nashville, Tenn.-based Vanderbilt Health said it will launch a new employee awards program in September that offers workers perks, discounts and a grand prize “staycation.”
The month-long Work Perks program will feature a website where employees can play games to earn perks in music and entertainment, health and wellness, dining and Nashville-area attractions, according to an Aug. 29 news release shared with Becker’s.
Workers will also be able to enter a drawing for a staycation. Five employees will win grand prizes including a one-night stay at a downtown hotel, passes to Nashville attractions, dinner at a local restaurant and a gift basket with items from Nashville businesses, including a winery and chocolate company, Vanderbilt Health said.
“We’re excited to show appreciation for our dedicated workforce in this way, and we’re grateful to so many generous partners to help make it happen,” Amy Schoeny, PhD, chief human resources officer, said in a release. “This is just one of the many benefits and perks that we offer to those who choose to pursue careers in making healthcare personal for our patients today and in the future.”
Work Perks will launch Sept. 5.
“We Hours” program
Marlton, N.J.-based Virtua Health told Becker’s it has instituted a “We Hours” program “to give employees more time to do the things that are important to them — from self-care to community service.”
The program offers eight additional hours of scheduled, paid time off per year for most of Virtua’s 13,000 employees.
“The ultimate goal is to encourage mindfulness and a healthy work-life balance,” Rhonda Jordan, Virtua’s executive vice president and chief human resources officer, told Becker’s. “We Hours are intended for colleagues to pursue something rewarding or fulfilling, such as volunteering, recognizing a religious or cultural event, or ‘recharging their battery’ with extra time away.”
Ms. Jordan said Virtua workers may also use the program for practical matters, such as a physician’s visit or attending to household repairs.
The program name stems from Virtua’s “Culture of We,” a set of guiding principles that include continuous learning and innovation, open communication and inclusive teamwork, among others.
A colleague committee developed the tenets in 2019, and employees are encouraged to share how they spend their We Hours in a private Facebook group, according to Ms. Jordan. She cited examples including photos from a visit to a botanical garden, a description of volunteer work helping nonprofit organizations, and a photo of the day one worker spent with her son, who’d been away serving in the U.S. Marine Corps.
“One of my favorite outcomes of the We Hours is that they invite us to learn more about our colleagues and the people, causes and activities that are most important to them,” Ms. Jordan adds.
Walking trails and well-being coaching
Charlotte, N.C.-based Atrium Health encourages all-around health through their LiveWell programs.
“[LiveWell] exists to support teammates in working meaningfully, eating healthfully, learning continuously and living fully … living their best lives so that we can deliver on the mission of Atrium Health,” Scott Laws, vice president of enterprise total rewards at Atrium Health, told Becker’s.
Physical health is encouraged through perks like discounted gym enrollment, tobacco cessation programs and on-site walking trails at Atrium Health facilities. Financial assistance is provided through free webinars and individual medication management consultations. One-on-one well-being coaches encourage employees to consider personal health.
Those that take advantage of the LiveWell resources are rewarded.
“By completing certain physical, personal and financial well-being goals — which include participation in wellness exams and programs or financial education — teammates are eligible for financial incentives, paid into their HSAs,” Mr. Laws said.
Adoption assistance
Springfield, Ill.-based Hospital Sisters Health System offers adoption assistance as part of its benefits package.
“HSHS provides financial support up to $7,500 per child for eligible adoption expenses to qualified colleagues,” Catie Sheehan, vice president of advocacy and communications at Hospital Sisters, told Becker’s.
Alicia Corman, an occupational therapist in the health system, was first to receive the benefit. After the adoption decree was signed, the human resources department helped her submit a breakdown of what the financial support would cover, Ms. Corman said in a video shared with Becker’s. The funds she received aided Ms. Corman and her husband in adopting their son.
“I’m very grateful because if you look across the U.S., adoption is not very supported in a workplace,” Ms. Corman said.
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Houston ER physicians say they were urged to avoid COVID tests, work sick
A group of emergency room physicians filed a lawsuit in March alleging representatives for their employer, American Physician Partners, discouraged them from testing for COVID-19 and pressured them to work while ill, according to the Houston Chronicle.
Brentwood, Tenn.-based American Physician Partners staffs and manages ER physicians at more than 15 Houston Methodist facilities, including hospitals and emergency care centers. The lawsuit, which does not involve Houston Methodist employees, centers on a dispute between eight physicians and APP.
The physicians allege APP is underpaying them and engaging in “unethical practices,” such as urging physicians with COVID-19 to work, as a way to boost revenue.
APP’s protocol, “discourages testing and disregards physician, staff, and patient safety when a doctor does test positive for COVID-19,” the lawsuit alleges. The physicians claim APP is putting “profit over patient.”
APP denied its involvement in the alleged financial damages in a response to the physicians’ complaint filed April 25. The company told the Houston Chronicle that it has been in discussions with the physicians since they raised concerns four months ago.
“We advised them at that time that their concerns do not reflect the facts known to APP and otherwise appear to be based on misinformation,” APP said in a statement to the Chronicle. “Thus we are disappointed these physicians — who represent a very small minority of the physicians APP partners with in the Houston area — have decided to move forward with this litigation. We remain open to continuing our dialogue with these physicians outside of the litigation, which, again, APP believes is without merit.”
Houston Methodist, which isn’t involved in or named in the lawsuit, said it cannot comment on the specific allegations, according to the Chronicle. “We are unaware of any ER doctor who came to work after testing positive for COVID-19,” a hospital spokesperson told Becker’s.
Read the full Houston Chronicle article here.
Rudeness is on the rise — why?
It’s not just you, and it’s not just in healthcare: Poor behavior ranging from the impolite to the violent is having a moment in society right now.
The Atlantic’s Olga Khazan spoke with more than a dozen experts on crime, psychology and social norms to suss out contributing factors to the spike in poor behavior, which she details in her piece, “Why People Are Acting So Weird,” published March 30.
Stress is one likely explanation for the bad behavior. Keith Humphreys, PhD, a psychiatry professor at Stanford, told Ms. Khazan the pandemic has created a lot of “high-stress, low-reward” situations, in which someone who has experienced a lot of loss due to the pandemic may be pushed over the edge by an inoffensive request.
Not only are people encountering more provocations — like staff shortages or mask mandates — but their mood is worse when provoked.
“Americans don’t really like each other very much right now,” Ryan Martin, PhD, a psychology professor at the University of Wisconsin at Green Bay who studies expressions of anger, told Ms. Khazan.
It doesn’t help that rudeness can be contagious. At work, people can spread negative emotions to colleagues, bosses and clients regardless of whether those people were the source of the negativity.
“People who witness rudeness are three times less likely to help someone else,” Christine Porath, PhD, a business professor at Georgetown University, said in the report.
Just as the pandemic has reaped high-stress, low-reward moments, it has brought on a level of isolation that has affected how people behave.
“We’re more likely to break rules when our bonds to society are weakened,” Robert Sampson, PhD, a Harvard sociologist, told Ms. Khazan. “When we become untethered, we tend to prioritize our own private interests over those of others or the public.”
Richard Rosenfeld, PhD, a criminologist at the University of Missouri at St. Louis, went one step further to describe society operating with “a generalized sense that the rules simply don’t apply.”
Ms. Khazan makes a point to distinguish mental health in the broader conversation about poor behavior.
“People with severe mental illness are only a tiny percentage of the population, and past research shows that they commit only 3 to 5 percent of violent acts, so they couldn’t possibly be responsible for the huge surge in misbehavior,” she said.
For a quantified look at how problematic behavior — including crime, dangerous driving, unruly passenger incidents and student disciplinary problems — has spiked, turn to journalist Matthew Yglesias’ deep dive, born from his observation that “the extent to which we seem to be living through a pretty broad rise in aggressive and antisocial behavior” is underdiscussed.
HENRY KOTULA 