Board Leadership Module 6: Influencing Performance and Inspiring Accountability

July 2020
National Rural Health Resource Center (The Center)

The Visionary Board Leadership and the Transition to Value 6-part video series, designed for critical access hospital board members, focuses on developing systems thinking and visionary leadership skills as keys to thriving in the changing health care landscape.

A suggested approach to use the content: Board of Directors should watch one of the six 15-20-minute videos every other month over the course of 12 months. Each module includes three parts: 1) educational content from subject matter experts, including interviews with rural hospital board members and CEOs sharing best practices and words of wisdom; 2) discussion questions for boards to consider how module topics apply to their organization and community; and 3) suggested activities for boards to put best practices into action. 

Reminder: Have your Board take the Pre/post-Training Evaluation after you complete Module 6. We hope the post-evaluation reveals a positive change in developing systems thinking and visionary leadership skills

Module 6


In our sixth and final module, we build on the ideas from previous modules by looking at ways that you as a board can direct others toward your vision for the future by creating a culture of accountability and feedback within your organization. As in past modules, other leaders will be joining us to tell their stories and share how they’ve done this in their organization. 


  • Influencing performance, inspiring accountability and the path to value
  • The role of a board in influencing performance and inspiring accountability
  • Creating a culture of accountability
  • Setting clear expectations
  • Giving effective feedback

Discussion Questions

  • What processes do you currently have in place for:
    • Setting expectations: Board expectations for the CEO and CEO expectations for the board?
    • Measuring progress and results?
    • Providing feedback?
  • What (if anything) would make these processes even more effective?
  • How can you use these processes to help your organization be successful and navigate the transition to value?


Based on your responses to the discussion questions above, develop a plan for implementing changes to your performance management processes and embedding them into the way your board and CEO work together. 

Evaluate the Series

Once you have completed the series, please take two minutes to complete three feedback questions in Survey Monkey. Your feedback will help us as we develop more trainings like this one! 


CAH Blueprint for Performance Excellence
This Blueprint is intended to be a tool for rural hospital leaders to implement a comprehensive systems approach to achieving organizational excellence.

How to Conduct a Chief Executive Performance Assessment in 10 Steps
A 10-step process for assessing your CEO’s performance in a systematic way.

Performance Management That Makes a Difference: An Evidence-Based Approach
This report takes a critical look at traditional performance management practices and shares recommendations backed by evidence.

Rural Hospital Toolkit for Transitioning to Value-Based Systems
This toolkit shares best practices for improving financial, operational and quality performance that position rural hospitals and networks for the future. It also outlines strategies for transitioning to value-based payment and population health.

Sample Chief Executive Office Performance Appraisal Process and Assessment Form
A sample form for CEO performance assessment created by the American Hospital Association.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.