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Posted on 06.18.2014

Preparing for “The Worst of Times” During Hospital Board Meetings

I was recently on a conference call with several members of a hospital executive team, and I found myself comparing municipal hospital board meetings to a Charles Dickens novel. Like public meetings of almost any stripe, hospital board meetings can be the best of times... unless, of course, they're the worst of times.

When the local Girl Scouts laud your facility for helping a dozen fourth grade girls earn first aid badges, or the father of new triplets thanks your medical staff for saving his wife and helping him build a family, it's all sunshine and unicorns in the board room.

But the combination of publicly elected / appointed lay people, anxious administrators and complicated issues can make hospital governance meetings very interesting forums. Layer on the additional dynamics of patient confidentiality, compliance concerns and other healthcare regulatory realities and you have all the makings for either 1) a really boring group nap or 2) a rootin' tootin' town hall where emotions and confusion (and sometimes, allegations) run high. 

Sounds like pre-French Revolution Dickensian Europe, right?

Most administrators know in advance if their next board agenda will provide for a snoozer or a showdown, so it's important to plan accordingly.  We've previously discussed tips for managing contentious meetings. But some board meetings, particularly those in which a sensitive issue may be raised, require a different kind of strategy.

In many instances, touchy subjects leave the hospital and its board in the unenviable position of being gagged by HIPAA, credentialing law, peer review protections and a host of other relevant regulations - even if a member of the public takes the podium to make unflattering (or even patently untrue) comments about the hospital. Retreating into the dark and sometimes defeating closet marked "no comment" can lead audience members at the meeting - which often include reporters - to conclude that the hospital either has something to hide or doesn't care about the issue.

If a hospital has a difficult item on the agenda, or knows that a negative issue may surface during the public discussion part of a meeting, it may want to consider preparing a fact sheet or policy overview to help guests and reporters better understand the context - if not the details - of a particular topic.  For instance:

  • Hospitals contemplating service line changes or workforce reductions could benefit from producing a single-page overview of statistics from peer facilities or national organizations. When reporters and community members read that 14 other hospitals in the state have undertaken layoffs in the last year, or nine other facilities have trimmed underutilized services, it helps provide context that all hospitals must focus on those services of greatest demand by their community.
  • Perhaps a hospital is lambasted in a letter to the editor by a patient who stormed out of the ER drunk, combative and mad because he wasn't seen by a physician within 30 minutes. Now he's promised to attend a board meeting to explain his mistreatment. The hospital won't be able to explain the circumstances of the patient's behavior in the ER, nor will they be able to disclose that he presented with a sprained big toe. But they could prepare a brief explanation that patients at ANY hospital are able to leave the facility at ANY time - even against medical advice. And they could provide the context that all patients are given medical screenings upon presenting in the ER and then treated by physicians according to the urgent or emergent nature of their condition.
  • Or maybe an unhappy patient has complained to a hospital CEO four times - always insisting the head of surgery be fired because of his bedside manner (which is usually pretty good). The CEO does her best to be responsive to the patient while explaining that the surgeon's behavior hadn't risen to grounds for firing. Undeterred, the patient appears at hospital board meeting and takes the trustees to task for being oblivious to her concerns. A brief and plain-language overview of the hospital's complaint resolution process shows that ALL complaints are investigated within 48 hours and ALL patients who share complaints are updated daily on the progress of a resolution to their concern.

Planning ahead - and working around issues that can't be addressed head on - can help "the worst of times" in hospital board meetings move along more smoothly.


Rosemary Plorin is President of Lovell Communications.  You can view more of her blog posts here. Connect with her at rosemary@lovell.com or @plorin.  Ã¢€‹

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