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Background

Marshall Medical Center (MMC) is an independent, not-for-profit healthcare organization located in Placerville, California that provides healthcare services across the western slope of El Dorado County and is a vital part of the local economy.  MMC is committed to creating a community where everyone can attain their highest desired state of health and well-being. 

In 2023, MMC’s board and executive leadership saw a chance to raise the bar on governance—to sharpen strategic visioning and decision-making, strengthen oversight, and respond more effectively to challenges and opportunities. To achieve this, MMC partnered with Witalis LLC to undertake a purposeful governance evolution.

Challenge

While MMC’s board met governance standards, they saw opportunities to elevate effectiveness and drive more strategic value for the organization. Key challenges included:

• Board meetings were often bogged down with management report-outs, leaving little time for strategic discussions.
• The board often focused on management issues (the how) instead of staying at the governance level (the why and where to).
• An outdated committee structure which was not aligned with MMCs current and future goals and priorities.
• The board struggled to anticipate and address emerging healthcare trends and competitive pressures.

Solution

MMC partnered with Witalis LLC to facilitate a purposeful governance evolution through the following activities:

• Provided education sessions on the board’s roles and responsibilities, the distinction between the board and management, governance best practices, healthcare trends and fiduciary, strategic, and generative governance.
• Facilitated board retreats – with pre-determined board discussion questions and dedicated time on the agenda for board discussion – to increase time in discussion, draw out the knowledge in the room, build trust and understanding and gel as a board.
• Conducted a “look under the hood” assessment of governance practices and provided recommendations and sequencing to smoothly manage the transformation.
• Restructured board committees to better focus on key board responsibilities, respond to changes in the market.
• Revamped board meeting agendas and materials to “stay at a governance level”, guide strategic action, and save time.
• Provided individual coaching to board officers during the leadership transition.

Results & Impact

• Better focus on key governance issues
• Better able to respond to changes in the market
• Increased Board discussion
• More intentional strategic action
• Better board and management dynamics and trust
• Better use of time

Conclusion

Through its purposeful governance evolution, the MMC board has greater clarity of its role and responsibilities, is structured to focus on the important governance topics, streamlined board operations, and elevated strategic decision-making and oversight. 

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