Leland Kaiser:

The role of boards in creating healthier communities

Kaiser: Hospital boards, collectively, have to make this thing happen. They have 12 essential roles:

1 Creating a mandate for change. The board has the visibility and the statutory authority to do this. It's the right exercise of power.

2 Convening community meetings in which it can happen. Someone has to invite you to the war.

3 Inviting other hospital boards to participate. Tell them, "There are interests larger than our competitive interests." Between you and your competitors, that's a lot of power right there.

4 Involving the business sector. The hospital can form a Business Health Institute. The business sector can become not just a negotiator, but a co-designer, of a re-shaped healthcare system. The board has to do that, because only they have the stature.

5 Facilitating this redesign as a catalyst, not as a dominator. You have to be careful that it does not become a hospital-based program.

6 Approving the interface ventures with other community agencies.

7 Supplying the seed money for projects -- and setting as a goal that within 90 days of the first meeting there will be programs in the community creating health.

8 Understanding that the hospital budget is an ethical document, expressed in such concrete numbers as the ratio of dollars spent on prevention to dollars spent on treatment. To understand this is to begin to re-engineer the organization.

9 Encouraging collaborative ventures with other medical entities, such as the medical society. You'll find that you can get more help than you need.

10 Helping the hospital change its role and function, get out of the arms race, and undergo a new birth experience.

11 Seeking enabling legislation that will allow hospitals to do what they need to do to build healthier communities. This might include, for instance, antitrust exemptions, waivers from Medicare and Medicaid, and special accreditation criteria.

12 Making sure that the board is not out there by itself. Work with the CEO and the staff.

This article appeared in the Healthier Communities Action Kit, Module 3, published by the Healthcare Forum