The Childrens Hospital of Philadelphia has delivered stellar clinical and financial performance for many years and has been widely recognized as one of the premier pediatric healthcare institutions in the country, recently earning its sixth No. 1 ranking in US News & World Reports annual evaluation of pediatric hospitals.
With this enviable track record and great reputation, why would our board of trustees know that it was time for a change?
We knew that our strategic goals of increasing national and international presence and the evolving regulatory and market challenges would require Childrens Hospital to operate in new ways. The outgoing and incoming board chairs agreed we were at an opportune point to look at how the board frames and executes its responsibilities.
Reflecting back over the work of last year, courageous and demanding board leadership was central to implementing significant changes to Childrens Hospitals governance: Expanded focus of the boards work: The board has always taken its fiduciary responsibilities very seriously, but this tended to eclipse the boards focus on strategic and mission considerations. We restructured the committees into two groupsmission and operating committees. The mission committees pushed the accountability of the board to advance why Childrens Hospital exists. The operations committees continue to address the more traditional accountabilities of the board. Redefined roles: With many long-standing board members, the board tended to function primarily through the whole board, rather than through the committees. The board chairs role has now become more direction-setting and less facilitative; the committee chairs are the primary advocates and activists (in partnership with management) for the issues of their committees. The board will next look at competencies and expectations for board members. Streamlined processes: The board and committees now meet on a consolidated calendar, that is, quarterly meetings held over two days, with presentations, discussions and supporting data that emphasize strategic and challenging issues, as well as satisfy fiduciary requirements.
Taken in aggregate, these changes have raised the expectations for the board. The board leadership made sure that Childrens Hospital was able to make changes quickly by working with a few implicit principles: Childrens Hospital first, Childrens Hospital last: The outgoing and incoming board chairs share a deep commitment to Childrens Hospital and its importance to the health of children. They consistently reminded board members that we were here for children and were going to build the governance structure to better enable the board to support Childrens Hospital and childrens health issues. Active engagement: The board chairs, along with the chair of the governance committee, knew that the more active the board members were in the process, the more invested they would be in the outcomes. With governance consulting support, all board members and members of the executive team were interviewed and participated in various discussions about findings and recommendations. Lead the way: Some of the changes were more significant than board members originally expected. The board knew it did good work, and so some did not see the need for major changes. The outgoing board chair helped members understand that it was time for change; the incoming board chair explained what the changes would support. Share the work: The board chairs recognized the need for the best possible leadership and staffing of committees. Management is upping its game in how we work with committee chairs; the chairs in return are actively taking on professional development.
Childrens Hospital has a stronger board; the increased energy among the board and management is significant. The board and committees are finding that the new structure, role definitions and consolidated calendar have increased focus and participation, and are optimistic, even in these challenging times, that the board and management as a team can advance Childrens Hospitals mission for childrens health to a new level.