How well prepared are hospitals for future crises? Board members perceive their hospitals as resilient for acute crises.

Resilience is an organizational capacity in day-to-day practice and crisis situation performance. A one of a kind crisis for hospitals is the COVID-19 pandemic. The long duration and magnitude of this crisis offers the opportunity to gain insight into the complexity of crisis management and organizational resilience of hospitals. This interview study therefore explored the organizational resilience of Dutch hospitals during the first 14 months of the COVID-19 pandemic. Nine board members of nine Dutch hospitals were interviewed by means of a semi-structured interview that was built on thirteen indicators of organizational resilience. The results showed that board members considered their hospitals as resilient on almost all indicators. Their judgments varied about how prepared and ready for future crises they considered their hospital. According to board members, hospitals are mainly prepared for "acute" short-term crises, thanks to good crisis leadership, open communication and strong networks. A crisis as long as the COVID-19 pandemic was unprecedented and therefore more difficult to deal with. In between the infection waves, work processes were reflected upon to learn, anticipate and respond more smoothly to successive waves. However, the enduring nature of the COVD-19 crisis presented complex organizational challenges. Crisis operations were eventually scaled down and hospitals had to manage the crisis and regular care as two companies side by side. Each crisis manifests differently. Fostering trust in healthcare staff and allowing them to act autonomously during crises, while diligently monitoring external influences and potential future crises, are therefore paramount in developing organizational adaptive capacities.

Ethical patient engagement in healthcare governance.

Health leaders are faced with a lack of public trust in healthcare governance. This waning trust relationship was further solidified through the pandemic. Improving the relationship between health organizations and the community/citizens/patient partners is a moral imperative of which ethical governance is a significant factor. This article will structure the ethical analysis of patient partners in governance through reviewing who we are, how we function, and what we do on governance boards. Taking an ethical approach will enable the promise of the value and impact of the patient partner to be actualized. Ethical governance that recognizes the significant contributions and value of engaged patient partners can be achieved and may be one of the significant levers required to transform healthcare.

Investigating the Role of Local Board of Health Governance on Local Health Department Policymaking Behavior.

OBJECTIVES: This study sought to identify groupings of policymaking behavior among local governmental health departments (LHDs) across the country and assess whether such groupings were associated with the governance activity of their board of health (BOH). DESIGN: We conducted latent class analysis (LCA) to identify possible classes of policymaking behavior among LHDs. Once classes were identified, we used multinomial logistic regression (MLN) to estimate the association between an LHD's policymaking behavior and the governance activity of their BOH. SETTING: 2019 wave of the National Association of City and County Health Officials (NACCHO) Profile Survey. PARTICIPANTS: All LHDs with BOHs in the 2019 NACCHO Profile Survey (n = 1003). OUTCOME MEASURES: Within our MLN, our primary outcome of interest was the association between an LHD's policymaking class (the main dependent variable) and the governance activity of its BOH (the main independent variable). RESULTS: Based on our LCA, we determined our sample to be composed of what we characterized as "Limited Policy-Involvement," "Average Policy Involvement," and "Expanded Policy Involvement" LHDs. Those in the Expanded Class were more likely to be involved across all policy areas compared to the Limited and Average class, especially among social determinants of health (SDOH)-related areas. Our MLN estimated that having a BOH active in legal authority was associated with an 86% increased chance that an LHD would be in the "Average Class" compared to the "Limited Class" and having a BOH active in partnership engagement was associated with an 86% more likely chance that an LHD is in the "Expanded Class" compared to the "Average Class." CONCLUSION: Using nationally representative data on LHD activity, we found distinct groups of policymaking behavior, including a quarter of LHDs that are highly active in traditional and SDOH-related policy areas. We also found that groupings of policymaking behavior, as indicated by class designation, are strongly associated with the BOH's governance activity.

Gender board diversity across Europe throughout four decades.

We present a Gender Board Diversity Dataset (GBDD), which provides a cross-country perspective on women in management and supervisory boards that spans between 1985 and 2020. The data covers 43 European countries and accounts for private companies in addition to the stock-listed ones. GBBD was created using firm-level Orbis data. Our measures are based on a sample of more than 28 million unique firms observed for nearly seven years on average and reporting data about nearly 59 million individuals on management and supervisory boards. We provide the measures at the level of industry, country and year (firm-level data is proprietary). We provide three measures. The first is the share of women among all board members in a given industry, country, and year. The second one is the average of the shares of women across firms in a given industry, country and year. We also provide a new measure: the share of firms in a given industry, country and year which report no single woman on their board(s).

The influence of non-state-owned shareholder governance on the governance level of state-owned enterprises--Based on the perspective of board resolution behavior and party organization governance.

With an increasing number of heterogeneous shareholders participating in corporate governance in reality, the assumption of shareholder homogeneity in agency theory is gradually relaxing in the modern field of corporate governance. The policy of mixed ownership reform in China provides empirical evidence for studying heterogeneous shareholder governance. To fully understand the governance effects of non-state shareholders, we employ the ownership proportion held by non-state shareholders among the top ten shareholders and the appointment of directors as measures for non-state shareholder governance. Using a panel fixed-effect model from the perspective of state-owned enterprises (SOEs) party organizations, we examine the impact of non-state shareholder governance on the governance level of SOEs. The study reveals that non-state shareholder governance positively affects the governance level of SOEs, with board resolutions playing a crucial role in this relationship. When party members serve as directors, the governance effect of non-state shareholders is more significant. Based on the aforementioned research findings, we recommend further refining corporate governance measures for SOEs within the context of SOE reforms. It is advisable to optimize the party organizational governance structure and leverage the synergistic effects of non-state shareholder governance and party organizational governance. Advancing reforms along the Pareto improvement path will contribute to establishing a distinctive corporate governance system for Chinese SOEs.

Engaging Governance in Workforce Strategy and Performance.

This column is a call to action for health care leaders to ensure that their governing boards make workforce an important part of their governance responsibility and oversight. Health care leaders need to take an active role in educating their governing board, identifying and monitoring appropriate workforce metrics, and engaging the board in developing and implementing a workforce plan. Workforce development is an important leadership competency and essential to today's health care organizations success.

Analysis of Race and Ethnicity Among United States Medical Board Leadership.

Background: The inequitable representation of women and members of racial and ethnic minority groups in leadership positions within academic medicine is an ongoing challenge with practical and realistic solutions. The purpose of this study was to assess the race and ethnicity of individuals in leadership positions among the 24 Member Boards of Directors (Boards) of the American Board of Medical Specialties (ABMS). Methods: We performed a cross-sectional analysis of the race and ethnicity patterns for individuals holding leadership positions among the 24 Boards of the ABMS as of March 1, 2022. Two independent coders with 100% concordance recorded race and ethnicity using online biographies and photographs. Percentages were compared to the Association of American Medical Colleges (AAMC) 2018 data reports. Results: Among 449 director positions, 415 (92.4%) were physicians. Within the physician subset, 12.3% (51/415) Asian, 8.2% (34/415) Black, and 3.4% (14/415) Hispanic individuals were identified. Women who are members of racial and ethnic minority groups have less representation than men of the same race. Of 24 Boards, 37.5% (9/24) had no Asian women, 50.0% (12/24) had no Black women, and 75.0% (18/24) had no Hispanic women. White physicians were overrepresented on 14 of 21 (66.7%) Boards compared to the proportion of active White physicians or White individuals in the United States general population. Conclusion: Disparities exist for members of racial and ethnic minority groups, particularly women from these groups. As a leader in academic medicine, the ABMS should ensure its Boards are diverse with respect to gender, race, and ethnicity. Diverse groups often contribute unique insights that support medical education, advance science, and improve clinical care.