Ten Tips to Streamline Information Flow to the Board

Increasingly, we are asked to help boards maximize the use of board members’ time in effectively stewarding the organization by running more efficient and effective board meetings. The current state of healthcare demands more of board members; however, their time is finite. One process to ensure your board time is optimized and board members can make the most informed decisions possible is through carefully crafted information flows. Below are 10 tips for streamlining the information flow to the board.

1. Adopt an inverted-style agenda with strategic and policy discussion items at the meeting’s outset and more routine items at the end. This will help ensure that important items are addressed fully and receive the attention needed.

2. Utilize executive summaries and consistent formatting of presentations to the board. This can be accomplished by utilizing one or more of the following:

• Solicit input from all board members related to upcoming board agendas. This can be accomplished via an agenda item submission form where everyone has input. Another approach is to solicit such input during routine committee meetings, since most board members sit on at least one committee.
• Require an executive-level approval process for information being presented to the board.
• Minimize content length. Comprehensive yet concise executive summaries that call attention to the most important issues and/or options should be provided at the outset of each presentation. Additionally, presentations should follow a consistent format. Some boards have gone as far as to limit presentation size to a set number of slides (i.e., no more than five).
• Upload materials to the board portal at least one week in advance of meetings.
• Hold presenters accountable to submitting materials within the appropriate timeframe.

3. Focus on generative discussions in the boardroom. While such discussions may be far-ranging, they should not be allowed to go off on tangents. Encourage the board chair to use a “heavy gavel” if needed to keep discussion on track.

4. Ensure prudent use of your consent agenda to free up time for strategic discussions during the meeting. Ask that board members notify the board chair and/or board support staff in advance if they wish to discuss an item on the consent agenda.

5. Standardize committee and executive session reporting. Focus on short verbal reports to the board on key policy issues or areas requiring special board oversight. These should happen as quickly as possible after a committee meeting occurs so that the board is informed promptly of need-to-know items. To help facilitate this:

• Ask each committee chair to provide a two- to three-minute update to the board related to its last meeting, using a common approach. Of course, remain flexible so that if a committee chair feels that the minutes suffice or there is nothing meaningful to report, that would be honored.
• Identify any committees that you believe require a regular, more substantive report, typically the finance committee and the quality committees.
• For any committee presentations, work hard to avoid regurgitating content that could have been read by members prior to the meeting. Instead, focus on key decisions or recommendations made by the committee, providing insights from the committee’s discussions, or teeing up complex issues facing the committee.
• The board chair should encourage questions, clarifications, or comments on committee minutes. It is easy to just “approve” the minutes, but it is important that productive discussion is happening, if necessary.

6. Develop a board calendar that outlines the schedule for all board and committee meetings for at least the next 12 months. When putting this together, consider the following:

• All board members should be considered “invited guests” for most committee meetings (with a couple of exceptions, such as executive compensation or those limited to independent members). Intentionally schedule committee meetings so it is easy for board members to attend these meetings if they choose to do so. For example, if your board meets quarterly, schedule committee meetings the day before and the day of the board meeting. If your board meets bi-monthly, schedule two committee meetings back-to-back, starting later the same day.
• Encourage some committees to meet jointly at least once a year. For example, the quality and the finance committees should convene jointly once annually since quality/value directly impact financial performance and financial resources determine how much is available to invest in quality initiatives. Similarly, the quality committee and the community health/benefits committee could find common ground around outcomes measures related to community health enhancement.

7. Require that clear board and committee annual work plans are in place. Work plans should ensure that over the course of each year, the board and each committee accomplishes all its designated responsibilities and duties. These work plans typically are updated annually, approved by the governance committee, and used by the committee chair to ensure that all elements of the committee’s charter are accomplished.

One additional benefit of developing such work plans is that this automatically creates a calendar outlining the focus area of each committee meeting. That way, any board member interested in a specific topic can plan well in advance to attend meetings of a committee of which he/she is not a member.

8. Each committee with a functional focus (e.g., quality, finance, or audit/compliance, etc.) should have a substantial “report out” to the full board at least once a year to: a) provide education around/trends impacting its focus area, b) review the issues or areas that are the focus of its current work, and c) outline its proposed work for the upcoming year. This report should be a concise presentation of less than 30 minutes with Q&A. That way, the board gets meaningful input into committee work as well as some education on key areas of the board’s responsibilities.

• Use a standard “template” for the update to keep all reports concise but meaningful.
• Where appropriate, encourage committees with overlapping areas of focus (e.g., the finance and investment committees) to share “center stage.”
• Recognize that committees exist to help the board fulfill its roles. The board should be made aware of the work of each committee and provide meaningful input into focus areas of the committees.

9. Hold an executive committee meeting regularly between board meetings. Use this as a vehicle to communicate and connect the work of all committees and to gather input on key agenda items for the next meeting. Provide brief written updates to the full board following this session.

10. Ask board members for feedback on meetings and be open to making improvements. Once a quarter do a short post-meeting assessment to keep a pulse on the success and areas of weakness regarding the efforts to streamline the information flow to the board.

Streamlining the flow of relevant information for the board, optimizing your committee structure, and providing robust industry education continue to define optimal board performance. Now, more than ever, engaging in these strategies and taking an intentional governance approach are needed to enable the critical board work required for success.