How You Make a DifferenceHow You Make a DifferenceHow You Make a DifferenceHow You Make a Difference

Northwestern Health Sciences University Board of TrusteesNovember 7, 2009

Ellen‐Earle Chaffee, Ph.D.Association of Governing Boards of Universities and Colleges

Role of the BoardRole of the Board

Look Up, Out, Around, Down

Fiduciary and Strategic

Fiduciary and StrategicFiduciary and Strategic

E • FIDUCIARY: Are we doing what we are supposed to 

• FIDUCIARY: Are we doing what we are supposed to 

Ensure organization fulfills its pp

do?pp

do?fulfills its mission

• STRATEGIC: Will we exist• STRATEGIC: Will we existEnsure 

organization’s STRATEGIC: Will we exist and succeed “forever?”STRATEGIC: Will we exist and succeed “forever?”

organization s long‐term viabilityviability

Fiduciary DutyFiduciary Duty

Duty of CARE Duty of LOYALTY Duty of OBEDIENCE• Decide and act in good faith

• Prudent person level of care

• Decide and act in the best interest of the organization, protect and support

• Faithful to founding documents

• Obey the lawcare and support

Where does it say, “Focus on finances???”

…and once in awhile, maybe……and once in awhile, maybe…

Strategic is NotStrategic is Not

Where are THEY looking, much of the time??Where are THEY looking, much of the time??

Strategic TopicsStrategic Topics

• Vision • ResultsVision

• Strategy

• Concepts

Results

• Long term

• Business planp

• Resources

• Future

p

• Customer  wants/needs

• Evidence

• Expertise

• Support

R di

• Competition

• Quality

Effi i• Readiness

• Productivity

• Efficiency

• Brand, positioning

Strategic QuestionsStrategic Questions

• What are we missing?What are we missing?

• What would be the 5‐10 year impact?

d hi d ?• How does this advance our strategy?

• What are the key national trends?

• Have you had a [comprehensive physical, vacation, great learning opportunity, …] lately?, g g pp y, ] y

• Is there anything on your mind that we can help you think through?help you think through?

Strategic Engagement at NWStrategic Engagement at NW

• Academic Affairs Committee topics– Integrative curriculum, faculty development, research, metrics and progress

• Finance Committee topicsFinance Committee topics– Recruitment, retention, IT, capital/equipment needs, financing the strategy, metrics and progress

• Development Committee topics• Development Committee topics– Financing the strategy, alumni goals, partnerships, metrics and progress

C i T i• Committee on Trustees topics– Balanced Scorecard development, becoming a strategy‐focused university and board, metrics and progress

Board‐Staff Indiv. CommunicationBoard Staff Indiv. Communication

B d f TBoard of Trustees

University President Board Chair

University Personnel

G P idFIDUCIARY, STRATEGIC, AND INTERPRETIVE

Governance Pyramid

Integrated Systems TheoryIntegrated Systems Theory

INTERPRETIVEINTERPRETIVEC lt l S i l S tC lt l S i l S tCultural, Social SystemsCultural, Social Systems

STRATEGICSTRATEGICBi l i l SBi l i l SBiological SystemsBiological Systems

FIDUCIARYFIDUCIARYh i lh i l

Governance as Leadership: Reframing the Work of Non‐Profit Boards by Richard P. Chait, William P. Ryan, and Barbara E. Taylor, NY:: Wiley, 2004.

Mechanical SystemsMechanical Systems

Integrative Health CareIntegrative Health CareINTERPRETIVEINTERPRETIVE

Encourage, expect, explain, provide….g , p , p , p

STRATEGICSTRATEGICAre we increasing VALUE for students/patients?Are we increasing VALUE for the university/clinic? 

FIDUCIARYFIDUCIARYRoot Cause Analyses

El t i P ti t R dElectronic Patient Record

Governance PyramidGovernance PyramidINTERPRETIVEINTERPRETIVELearn, communicate,

STRATEGICSTRATEGICStrategic thinkingBalanced scorecard

FIDUCIARYFIDUCIARYPolicies, audits, consultants