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Worksheet: Committee Reporting Structure

One major issue for systems to work out is communication and alignment between local board committees and the system board and committees. Below are some tips to ensure that the system and local board committees work together smoothly:

1. The charter for the local committee should mirror the charter for the system level committee (of course modified to be relevant locally). Local board charters should start with a preface/context that indicates that the role of the local board committee (e.g., quality) is to ensure that the quality priorities of the system and its counterpart committee are achieved locally.

Below is sample charter language for a local quality committee (also appropriate for other committees):

  • Context: In concert with the plans and priorities of the system health board and its quality committee, the local quality committee provides reports, oversight, advice, and direction to the local governing board and executive team. Consistent with the system health board’s priorities, this local quality committee establishes and monitors priorities for the local organization pertaining to quality, safety, patient experience, cost-effectiveness, and enhancing the health of the region they serve.
  • Purpose: The local quality committee will help the system health board and local hospital achieve their quality, safety, patient experience, and cost-effectiveness goals.
  • Responsibilities: In concert with the plans and priorities of the system health and local board, the local quality committee shall…

Following this, the list of responsibilities of the local quality committee is essentially the same list as the system quality committee—except that items not relevant to local level are excluded.

2. Use system-wide targets (for quality, finance, other committees) to establish local targets. Many systems do this “for” the local board (e.g.,
they set up a local balanced scorecard tied to the system balanced scorecard). If the system does not do this, the local committee should request that the system articulate its objective measures of success related to its functional role and use these to establish and monitor local targets.

3. The system should provide system-level performance metrics to the local committees to complement local performance (this would only apply to committees such as finance and quality). This means that the local committee routinely reviews its performance in relation to the system as a whole.

4. If system-level committees use an annual work plan (e.g., focus on specific aspects of their charters during specific meetings during the year), align the local committee annual work plans and agendas to those of the system.

5. Provide educational information that is used to inform committee work at the system level, and utilize this same content/information locally.

6. Consider whether any of your local committees could invite a member of the system’s counterpart committee to serve as a member locally (this would work best when geographically proximate). This facilitates direct cross-fertilization of ideas and approaches.

Below is a checklist for system committee structures:

  • Does each committee have a clear charter?
  • Are lines of connectivity between system and affiliate committees clear?
  • Is the authority and responsibility of each committee explicit?
  • Is there a unified rhythm of governance work across the system?
  • Do board chairs and like-committee chairs meet regularly?
  • Do system boards routinely solicit input from affiliate boards?
  • Do affiliate boards routinely query system boards to ensure alignment?

The Governance Institute – January 2018
Marian C. Jennings, President – M. Jennings Consulting, Inc.
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