Board Orientation Manual:

Providing Essential Knowledge and Solutions to Achieve Excellence in Healthcare Governance, Fifth Ed.

As a new board member, you are beginning a period of service that brings with it prestige, credibility, influence, and personal satisfaction. You bring a lot of time, effort, and a sincere desire to improve the health of your community.

Most board members sitting on non-profit hospital and health system boards are volunteers. America’s great tradition of voluntarism supports the idea that people can willingly band together for a common purpose. Thus, outstanding citizens freely devote time and energy serving on boards of hospitals and health systems from which they derive no tangible gain. For the most part, directors serve because of a genuine interest in the quality of healthcare and a sense of service to their community.

The legally constituted governing board of directors holds the healthcare organization in trust. In order to fulfill this trust, it must be the ultimate source of authority—and it must have overall responsibility—for the institution. In the eyes of the law, directors have a fiduciary obligation that cannot be divested through delegation. Directors are held to a very high standard of conduct. They are charged with safeguarding the assets of the organization, protecting the patient from harm, and not receiving any personal gain from their relationship.
The 21st century hospital or health system board is overseeing a much more complex organization than in years previous, and the market dynamics facing healthcare are unprecedented. This makes the job of non-profit directors more important and complex, emphasizing the need for a strong orientation program and ongoing education to remain at the forefront of challenges and issues facing the organization the director serves.

This orientation manual gives you important points about governance. Some of the information may be elementary to you, but overall, the manual offers a comprehensive guide to your responsibilities and roles. It also offers tips you can take with you into the boardroom, and outlines governance trends that may affect you in the next one to three years of your tenure. Finally, it gives you specific questions you will want to have answered as your organization puts you through its board orientation program.

Many new healthcare directors come from outside the world of healthcare. For this reason, we have also included basic background information on hospital organizational structure and some key dynamics that have influenced and continue to influence the direction of healthcare.

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