06-11-2002 PTRC Agenda - Laserfiche WebLink

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• Rural hospitals may provide the most clear (and unfortunate) example of this approach. When the hospital in Elbow Falls was founded in 1954, its purpose was to "enhance the health of the people of the community," and building an acute inpatient facility made eminent good sense in light of the realities of the time. In 1999, though, the purpose of enhancing the health of the people of Elbow Falls remains critical, but is unlikely to be well served by the provision of acute inpatient services in Elbow Falls. Nonetheless, when the board of that hospital gathers for its annual "strategic planning" retreat, it will consider an array of options for improving the performance of the Elbow Falls Hospital. How much better the organization would be served if the board went back to its purpose, and asked, "how can we best use the resources available to enhance the health of the people in this community over the next 5 years?" The answer to that question is not likely to be some form of inpatient care. A fourth reason why boards don't do real planning is that the information they base their planning decisions on has to do largely with the performance of the organization, not the larger trends and issues confronting the community they serve. Presentations by the professional or management staff on the internal workings of the organization, no matter how factual or well-intentioned, will lead boards down the path of management planning, and keep them off the • much higher road of governance planning. On the other hand, the more external perspectives (including those considered avant garde or otherwise aberrant) that come before the board, the more likely they will be to be drawn onto that high road. Again, those management-oriented folks who make up boards are easily tempted away from the hard work of governance planning to the much easier and more familiar work of management planning. It is clear that the kind of real strategic planning that is advocated here cannot be accomplished in a two-day retreat (though such sessions are important). It must become the long term, enduring content of the board's work. It requires consideration of many factors and perspectives over a lengthy time period. It depends on thoughtful reflection, productive dispute resolution, the ability to deal with subjective information, and many other processes that take time and energy. Above all, it depends on the ability of the board to learn together. It is the real work of the board, and board members should not be distracted from it by concerns about how the organization is managed --that's for the CEO to worry about. i