A taxonomy of hospital governing boards
The purpose of this study was to develop an empirical taxonomy of governing boards in U.S. community hospitals. The taxonomy was developed using a configurational perspective and with cluster analysis according to three main areas of board responsibility-mission and strategy setting, performance evaluation and oversight, and external relations. Results of the cluster analysis were validated using ANOVA tests and discriminant analysis and were reviewed by industry experts. In a sample of 1334 community hospitals, a 5-cluster solution was identified. Assessment of the agreement between slip-half subsamples using Kappa statistic suggested that the cluster solution had high internal reliability (Kappa=0.87; p<0.0001). ANOVA tests using the entire study sample showed that the inter-cluster variance was statistically significant on the three board functions. Based on discriminant analysis, 97.5% of the hospital governing boards were determined to be correctly classified through cluster analysis, suggesting high internal validity. Systematic differences were found between clusters in terms of hospital and environmental conditions. While it is recognized that a clear goal of hospital governing boards is to build and sustain an effective hospital, our findings indicate that what boards actually do to accomplish that goal differs substantially. As the function and performance of hospital governing boards continue to receive attention, the taxonomy developed in this study would provide policy-makers, healthcareexecutives, and researchers a useful way to describe and understand the role of hospital governing boards. The taxonomy may also facilitate valid and systematic assessment of governance performance in future research.
