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Building Efficient & Effective Governance

Become a Best-in-Class Board with Board Builder

Since 2010, 142 rural hospitals have closed. This situation has had a detrimental impact on the health and well-being of the patients and communities they served. And at least 40% of rural U.S. hospitals are in jeopardy of shutting down soon—a situation that could potentially leave millions of Americans in smaller, less prosperous communities with no access to nearby emergency care or critical care facilities.


If your Board isn’t spending critical time in strategy discussions and making decisions about the future of your organization because of lengthy Board meetings filled with retrospective reports, unproductive discussions and less-than-engaged members, your hospital may be at risk.


These strategic conversations are critical. 65% of Boards report spending less than half of their meeting time in to active discussion, deliberation and debate about the strategic priorities of the organization, according to the American Hospital Association's 2022 National Health Care Governance Survey Report. If the average Board spends less than half of its valuable time on optimal decision-making, it is difficult to imagine how it can provide the strategic direction leadership needs to develop and execute tactics to ensure the viability of the organization.

A high functioning governing Board is a key asset in moving an organization forward.

Here’s what it takes to create a best-in-class Board:



Be vulnerable as organization leaders to acknowledge and embrace the opportunities for improvement.



Dedicate specific time to concentrate on, think about, discuss, and address governance processes.



Accept responsibility and accountability to enhance efficiency and effectiveness.

Two men sit in front of each other

Only Board Business’ Board Builder takes this approach to Recognize, Focus and Execute so your Board is distinguished by its excellence in governance.

A hospital Board chair made this statement after addressing her organization’s governance processes:

Tracy provided an extremely valuable resource for our board. We worked closely with her on board evaluations, committee structure, officer role development, agenda and information management, strategic planning and by-laws clarification. She was a valuable "go-to" person for questions regarding legal issues; statute clarification; and executive recruitment, evaluation and compensation. She was definitely helpful in guiding our board toward stronger governance.


-L. Hertz, Board Chairperson

We know Board Builder will lead to efficient and effective governance processes. By investing time and attention now to evaluate and enhance Board operations, the result is more time for generative thinking to achieve organizational sustainability for years to come.


Allow us the opportunity to prove it to you. Take a step toward becoming a best-in-class Board by scheduling a complimentary consulting call today using the Book button.

Our Services

Team Meeting
Conference Room
Lead presentations during meetings

Governance consulting

Board education and governance development

Board performance evaluation

Board leadership and executive succession planning

Why Choose Us

Expertise: Our team has been exposed to good and not-so-good governance practices from attending over 1000 Board meetings. We bring these best practices and many other valuable resources to every engagement.

Tailored solutions: We understand that every organization is unique, so we take time to ask questions, listen to your challenges, and work closely with you to develop specific solutions to meet your needs.

Experience: Our team has served on Boards, reported to Boards and supported multiple Boards. These perspectives provide the necessary experience to understand your governance challenges.

Life is even better

Through the delivery of a new governance structure, Board meetings have undergone a true transformation. The agenda is focused on discussion and decision-making. Briefing reports are delivered to Board members in advance of meetings and include questions for generative thinking. Senior leader presentations are focused.

The Board is attracting top notch talent. Better yet, the skill sets and perspectives of a diversified Board lead to discussions and decision-making about new services which in turn results in more growth and increased revenue. The process of creating more efficient and effective governance has sustained the organization!

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