C7 reframing governance

Reframing Governance: Leading Practices from Ontario’s Health System Gwen DuBois-Wing, RN, MHA, PhD, PCC ISI Fellow, Fielding Graduate University June 13, 2018 @GDuBoisWing © International Copyright June 2018 G. DuBois-Wing

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Presenter Disclosure Presenter: Gwen DuBois-Wing Relationships with financial sponsors: Grants/Research Support: Speakers Bureau/Honoraria: Consulting Fees: Patents: Other:

None None None None None

Objectives for this Session  Profile how higher performing boards adopted Governance as Leadership (generative mode).  Share leading practices that:  Promote a culture of inquiry in the boardroom  Impact the organization’s mission.

 Explore opportunities to adopt leading practices in your boardroom.

Performance

Problem Boards or Board Problem?

Reform

Purpose

(Chait, Ryan & Taylor, 2012)

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CEO Engagement

Board/CEO Engagement

Board Engagement

(Chair, Ryan & Taylor, 1996) 6

“We all make up a circle. In the center of that circle is a tree, and everybody’s view of the tree is different. One person says, ‘There’s fruit that’s ripening.’ Another person says, ‘There’s a blight on the tree.’ A third person says, ‘There’s where it got struck by lightning.’ And it’s all of those things! If I’m not seeing the blight, I need the person who is to tell me so. I can’t operate without that intelligence or I’ll be going off halfcocked.” ~ Michael Green, 2014

Governance as Leadership: Modes

(Chait, Ryan & Taylor, 2005) 8

Modes of Governance  I. Fiduciary. Stewardship of tangible assets. Focus – oversight. Ensure legal & financial accountability. Deploy resources wisely; Evaluate leadership & hold CEO accountable. Monitor results.

 II. Strategic. Partner w/ senior staff. Focus – foresight. Scan internal & external environments; Review, modify & adapt strategic plans/vision. Evaluate strategy performance against measures.  III. Generative. Sense-making, discernment & framing issues. Focus – insight. Engage in sense-making, meaningmaking & framing complex challenges.

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When should the generative mode be used in the boardroom?

Creating & Sustaining a Generative Mode in a Boardroom: Research Purpose  Explore factors that a board chair and CEO perceive create and sustain a generative mode of governance in a boardroom.

Sample  15 Board Chairs and 15 CEOs/EDs  30 interviews • 9 hospital Board Chairs and CEOs • 5 CHC Board Chairs and CEOs/EDs • 2 CCAC Board Chairs and CEOs © International Copyright June 2018 G. DuBois-Wing

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Major Findings: Themes What do board chairs and CEOs perceive as factors that create and sustain a generative mode of governance in a boardroom?

Six major themes:      

Culture of inquiry Board/CEO relationship Leadership role of the Board Chair Board engagement Expertise and skills Time

Seventh theme:  Context © International Copyright October 2016 G. DuBois-Wing

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What do board chairs and CEOs perceive as factors that create and sustain a generative mode of governance in a boardroom?

Leadership Board/CEO Role of Chair Relationship

Time

Generative Mode

Culture of Inquiry

Board Expertise/ Engagement Skills

Š International Copyright June 2018 G. DuBois-Wing

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Theme: Board Relationships Board Chair/CEO Relationship

Board Chair/Board Relationship

Board Relationships

Respect

Trust

Board as a Team © International Copyright June 2018 G. DuBois-Wing

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Theme: Leadership Role of the Board Chair Setting the Tone Agenda Setting

Leadership Role of the Board Chair

Facilitating Healthy, Productive Discussions Asking Important Questions Being Open to Feedback Fostering Board Wholism

Š International Copyright June 2018 G. DuBois-Wing

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Theme: Culture of Inquiry Learning Board

Board Information

Culture of Inquiry Discerning

Sensemaking

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Culture of Inquiry: A Learning Board  Exploited various opportunities for learning (learning organization)  Various formats: retreats, provincial conferences, self-directed learning, governance sessions, etc.

 Storytelling (i.e. Client stories)  Tours: Internal & external

 External experts  Dedicated resources for board development © International Copyright June 2018 G. DuBois-Wing

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Culture of Inquiry: Board Information

© International Copyright June 2018 G. DuBois-Wing

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Theme: Board Engagement Board Participation

Use of Board Capital

Engagement at Boundaries

• Active participation • Preparation • Attendance

• Intellectual • Social • Political • Reputational

• Internal • External • View of broader health system

© International Copyright June 2018 G. DuBois-Wing

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Theme: Expertise/Skills  Purposeful, rigorous recruitment process • Use of skills matrix • Diversity • Balancing skills and diversity – “an art”

 Building a recruitable board  Context matters • Current needs of organization • Environmental realities

© International Copyright June 2018 G. DuBois-Wing

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Theme: Generative Mode of Governance Focus on Consequential Issues

Comfort with Ambiguity

Generative Mode

CEOs want to be Challenged

Changing the way Business is Done

Generative Conversations Š International Copyright October 2016 G. DuBois-Wing

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Generative Mode: Changing the Way Business is Done  Rethinking governance: • Beyond traditional lens • Trimodal governance

 Systems perspective: • Focus on the broader health system • Being part of the solution

 Systems leadership  Commitment to excellence: • Focus on quality • Person/family/community-focussed • Accountability

© International Copyright June 2018 G. DuBois-Wing

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Creating a Boardroom Shift

Governance: Shifting the Question “We must resist the urge to assume that task and structure are the sum total of governance. We can more easily do this if we shift our thinking from “What is governing?” to “Toward what ends are we governing?”

(Trower, 2013)

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Shifting the Boardroom  Crafting the board agenda • Goals

 Meeting preparation  Board information: • Right amount • Types & purpose • Technology, access

© International Copyright June 2018 G. DuBois-Wing

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Shifting the Boardroom  Dialogue, deliberation, sensemaking • Framing • Time • Places/spaces

 Leadership • Distributive

 Other strategies & tactics

© International Copyright June 2018 G. DuBois-Wing

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Creating & Sustaining a Generative Mode in the Boardroom Fully engages the board

Enhances board & organizational performance

Changes the way board work is done

Focus on Consequential Issues

Governance as Leadership

Engages the “Collective Mind”

© International Copyright June 2018 G. DuBois-Wing

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Contact Information Gwen DuBois-Wing DuBois-Wing + Associates Email: gdubois-wing@tbaytel.net @GDuBoisWing

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