Talk from the Top-November 2018

Governance – A Framework to Value and Success

Talk from the Top-November 2018
Paula Kyburz, RN

“Governance planning doesn’t happen overnight, but if you structure it well, it sets the stage for success.”

Governance – the word by itself seems harmless enough.  However, many healthcare organizations do not put governance in place and for many making the attempt, they struggle to integrate it effectively into their organizations.  An organization may see governance as additional bureaucracy and red tape.  Governance, when done well, can give the framework to help ensure an organization is maximizing the value of their initiatives while utilizing limited resources and staying within tight fiscal constraints. Wanting to get some insight into what helps organizations be effective with their governance implementation, we talked to HSi’s own Senior Director, Paula Kyburz, about her years of experience helping organizations effectively deploy their governance strategies and structures with an eye on sustainability.

What does Governance mean to you and do you think people are clear on what it is?

Governance is an area of confusion for many.  They don’t have a strong sense of what it is and what it isn’t.  Some organizations will quickly put in a structure for a project to provide high level strategy and call it governance.  Their efforts, as well intentioned as they may be, can be unsuccessful because the purpose is unclear, and roles and expectations are undefined.  Quality governance programs are a structured methodology for the organizational management and oversight of long-term initiatives and programs.  They are highly structured with a plan outlining the long-range goals and objectives.  Most importantly, an effective governance program will define the reporting structure and the responsibilities of each participant.  It is the accountability piece that can make or break a governance program.

What is the biggest hurdle you have seen for organizations to get a proper Governance structure put into place?

One of the greatest hurdles in establishing a proper governance structure can be accomplishing executive buy-in.  With executive leadership and input, the appropriate key stakeholders can be identified, and active participation appropriately influenced by senior leadership.  Without the right stakeholders and executive support, defining the governance strategy and organizational direction becomes extremely difficult.

What should an organization expect to see in terms of benefits when a highly functioning Governance structure is in place and operating well?

With a highly-functioning governance plan in place, organizations will see several benefits.  Through a clearly defined intent of the work to be performed, organizations limit questions regarding how the work is managed, approval processes are in place and understood, communication and training strategies are defined, and participants know the critical success factors in play.  Governance allows organizations to be on the same page as they move forward as resources are prioritized accordingly and issues (through a pre-determined resolution process) are effectively addressed.  For service and support departments such as IT, prioritization and clear delineation of strategy improves the overall effectiveness of the utilization of IT resources. Providing oversight and strategic steering, governance  also identifies who is ultimately responsible and, above all, ensures the work performed garners the value desired.  Whether it be triple aim goals or key performance initiatives or other organizational objectives, governance educates the audience to the purpose of the plan and provides the alignment of resources and necessary dollars to achieve the desired outcomes.

How does bringing in HSi help an organization trying to take on this challenge?

By utilizing experienced external resources from HSi to assist in the organization and implementation of a governance structure, healthcare organizations are provided director-level skilled resources who work as facilitators of change on their behalf.  Working closely with executive, operational and IT teams, HSi can serve as the initial coordinator between the groups, draft the governance plan, and move communication forward as an objective third party.  Adding in HSi’s success implementing governance strategies with other health systems, organizations get the expertise of a broader knowledge base of what works well, and conveyance of potential obstacles experienced elsewhere as process guidance occurs.  Having done these numerous times, HSi also brings to the table ready-to-go templates to customize specifically to meet an organization’s unique requirements saving valuable time and customer expense.

To be successful in implementing your governance plan, HSi offers up a few tips –

  • • Identify executive sponsors up front
  • • Create a charter explaining the pieces and parts of the problem you are trying to solve and the outcomes you seek
  • • Be clear in what you are trying to accomplish to build an understanding of why active participation by everyone in a governance structure is important

In closing the conversation, Kyburz added this advice to organizations: “Take the time to do it. Governance planning doesn’t happen overnight, but if you structure it well, it sets the stage for success.”

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