Governance Toolkit


THT’s online Board Governance Toolkit provides you with the necessary tools to lead and support your hospital or health care system.

Whether you’re building your board from the ground up or seeking improvements and efficiencies for your current board, you can begin here with best practices for good governance.

New Board Member Orientation

When a new trustee joins your board, it is vital to share a proper introduction to your organization. Setting expectations for their roles and responsibilities lays the foundation for their work ahead. A new board member orientation should be formalized, consistent and updated regularly.

Board Member Recruitment

Just like building a championship sports team, building an effective board does not happen overnight and is an ongoing process. However, if done correctly, it can ensure the success, longevity and viability of an organization When recruiting new board members, it is vital to envision and identify the proper mix of competencies, demographics, experience and influence to form a cohesive team and benefit your hospital.

Efficient and Effective Board Meetings

Running an efficient, fair and orderly board meeting is the goal – but not always the reality – for trustees and hospital leadership. The following tips and reminders will help your board run a successful and productive meeting.

Parliamentary Procedure

Rules and guidelines enable groups to come together to discuss and make decisions in a consistent manner. Most organizations with a governing body adhere to some form of parliamentary procedure, with many using Robert’s Rules of Order, a manual of rules and practices to help conduct fair and efficient meetings.

Health Equity and Health Disparities

Improving quality and the delivery of health care is a steadfast goal for many hospitals and health systems. A key component of quality improvement and creating healthy communities is working to eliminate health disparities and advance health equity. This is especially important in Texas, where over the last decade, there have been substantial changes in our state’s population and demographics.

Board Self-Assessment & Individual Evaluation

One of the most important pillars of excellence in governance is conducting a board self-assessment; it is often seen as a hallmark of high-performing boards. Board self-assessments and individual board member evaluations provide an opportunity to reflect on performance, collect data on all areas of board oversight and allow board members to further understand the breadth of their role – individually and as a whole governing entity.

Texas Open Meetings Act and Public Information Act

Governmental hospitals in Texas, such as hospital districts, hospital authorities, and county hospitals, are subject to the requirements of the Texas Open Meetings Act and the Texas Public Information Act. Health care trustees of governmental facilities need to be familiar with the key requirements of these laws to ensure compliance.

Key Issues

Below are resources – including white papers, THT publications and webinars – for hospital and health care system boards to explore in four issue areas of board oversight:

Hospital Finances & Reimbursement
  • How Hospital Finance and Reimbursement Works in 5 Steps
  • Finance and Reimbursement Workbook
  • Health Care Professional Liability Insurance’s Changing Market: What Trustees Must Know
  • Webinar: Rural Hospital Financing: Bringing Numbers to Life
  • More Finance & Reimbursement Articles
Quality & Patient Safety
  • Defining Quality and The Current Landscape (credit: THT Trustee Guidebook: Quality& Patient Safety)
  • The Board’s Role in Quality & Patient Safety & Landscape (credit: THT Trustee Guidebook: Quality& Patient Safety)
  • The Critical Access Hospital Board’s Role in Quality Improvement Projects
Physician and Recruitment & Retention
  • Help Wanted!: Physicians
  • Ten Keys to Enhancing Physician Relations and Reducing Physician Turnover
  • Physician Contracting
  • Webinar: Aligning Governing Boards and Physician Leaders
Board Diversity & Health Equity
  • Who’s at the Table? THT Trustee Demographic Study and Toolkit
  • Addressing Healthcare Disparities Through Governance
  • Webinar: Diversity and Inclusion Strategies to Achieve Health Equity