Orlikoff James E
Orlikoff & Associates, Inc., Chicago, USA.
Front Health Serv Manage. 2005 Spring;21(3):3-12.
Healthcare boards are entering a new era of heightened accountability, scrutiny, and reform. Sarbanes-Oxley legislation, Internal Revenue Service scrutiny, pressure from creditors and bond insurers, activist state attorneys general, media attention, and other forces have sharply increased awareness of the importance of governance and have also raised the bar on what is required of boards and what is considered best-practice governance performance. Yet good governance cannot be legislated. The structure, composition, and specific required functions of boards can be legislated or mandated, but the effective function of boards cannot. At the same time that governance faces this new era of accountability, it is also being bombarded with the legions of monumental challenges in the tumultuous healthcare field. Chief executive officers and their boards must be willing to recognize the challenges and risks to the field of governance in general and to their boards in particular. Furthermore, they must be willing to implement new strategies and approaches for successful governance, including becoming compliant with Sarbanes-Oxley requirements; conducting a comprehensive audit of the structure, function, composition, and culture of the board; and seeking board members from outside the community, among many others.
医疗保健委员会正步入一个问责性增强、审查力度加大和改革深入的新时代。萨班斯-奥克斯利法案、美国国税局的审查、债权人和债券保险公司的压力、积极的州检察长、媒体关注以及其他因素，都极大地提高了人们对治理重要性的认识，同时也提高了对董事会要求以及最佳治理绩效标准的门槛。然而，良好的治理无法通过立法实现。董事会的结构、组成和具体规定的职能可以通过立法或强制规定，但董事会的有效职能却不能。在治理面临这个新的问责时代的同时，它也在动荡的医疗保健领域中受到众多巨大挑战的冲击。首席执行官及其董事会必须愿意认识到治理领域总体上以及其董事会尤其面临的挑战和风险。此外，他们必须愿意实施成功治理的新战略和方法，包括遵守萨班斯-奥克斯利法案的要求；对董事会的结构、职能、组成和文化进行全面审计；从外部社区寻找董事会成员等等。
