The Economics of Agrobiotechnology

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Healthy Boards An Introduction to Governance
for Health Care Organizations
James N. Barnes, Ph.D. Assistant Professor
Director Program Leader for Community Rural
Development Delta Rural Development Center
(DRDC) LSU Agricultural Center Phone
318.428.4029 E-Mail jbarnes_at_agcenter.lsu.edu
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Message Number One
Rural health care business is complex and
therefore rural health governance is complex

Why is rural health business complex from a rural
hospital perspective?
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Business Complexity Factors

• ? Payment system is complex
• ? Patient mix
• ? Physician recruitment is costly
• ? Health care regulations change frequently

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Added Rural Factors

• ? Small base of people in local area willing to
  serve on hospital board
• ? Limited knowledge of health care business
• ? Usually volunteer labor/recruitment
  difficulties
• ? Closeness creates conflict resolution
  problems

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Message Number Two
Strengthening the Governance Skills of board
members is one approach that can strengthen the
governance and performance of rural hospitals
and can create a culture that supports the
development of trust among members

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Programs to Strengthen Governance Skills
Basics of organization and behavior for high
performance Healthy Boards Other
modules Parliamentary Procedures Meeting
Management Conflict Resolution Team/Leadership
Development Strategic Planning - BSC


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Teaching Methodology
Present research based principles for good
governance Case study approach (Yin,
1994) Interaction with group members and
analysis of an existing board situation Develop
strategies to resolve board situation USING
principles for good governance




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Some Elements of the Healthy BoardsWorkshop
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Healthy Boards Model
Accountability Trust
Social Principles
Organizational Principles
Healthy Governance
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An Assessment Exercise
Questionnaire
Discuss scores
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Scoring Combine your scores for the preceding
statements as indicated below. Absence of
Fear of Lack of Avoidance of
Inattention to Trust
Conflict Commitment
Accountability Results Statement
4 ____ Statement1 ____
Statement 3 ____ Statement 2 ____
Statement 5 ____ Statement 6 ____
Statement 7____ Statement 8
____ Statement 11 ___
Statement 9 ____ Statement 12 ___
Statement 10 ___ Statement 13 ___
Statement 14 ___ Statement 15
___ Total ______ Total _____ Total______
Total______
Total______ A score of 8 or 9 is indication
that you serve on a healthy board. A score of
less than 8 indicates that your board could
benefit from additional governance
training. Based on the book The Five
Dysfunctions of Teams by Patrick M. Lencioni
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Top Ten Commandments for a Healthy Board Member
Thou shalt honor thy community
Thou shalt be honest and fair to those who serve
you
Thou shalt evaluate fairly those who serve you
Thou shalt not forsake thy job for political gain
Thou shalt be an informed, active member
Thou shalt be prepared for all meetings
Thou shalt not micro-manage
Thou shalt keep thy mouth shut about closed
sessions
Thou art not infallible. Thou can learn new
tricks
Thou art only one board member, not the big cheese
Source Oklahoma State School Board Association,
2004.
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Remember your role
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Research References for the Healthy Boards
Program

• Barnes, J., Woods, M., Frye, J., Ralstin, S.
  (2004). What is a healthy board? Oklahoma
  Cooperative Extension Service, F-929.
• Holland, T. (2002). Board accountability Lessons
  from the field. Nonprofit Management and
  Leadership. 12, (4) 409-428.
• Sonnenfeld, J. (2002). What makes great boards
  great. Harvard Business Review, 9, 1-8.

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Some Additional Board Governance Resources

• Visit the Journal of Extension (JOE)
• The Determinants of a Healthy Board
• http//www.joe.org/joe/2006october/tt1.shtml
• Building Trust in Local Community Organizations
  http//www.joe.org/joe/2006august/tt6.shtml

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Impacts of HB Program

• Short term learning of principles and increase
  in trust/accountability among board members
• Medium term adoption of other modules to
  resolve conflict, set a strategy, etc.
• Long term how has governance of operations
  changed since program (turnover, financial)