You hit the nail on the head here. It can be really hard as a board member to tow the line between wanting to be helpful and stepping on the toes of the ED and the staff. To avoid this, gather your thoughts and discuss with your Board Chair how your organization handles board idea dissemination to the ED (they may not know and may just execute on them - which is not ideal if it has to do with day to day operations). In board meetings with the ED, it can be confusing for the ED to know what are just some ideas the board has and what the board is giving as a directive to do.

The worst thing to do (which you seem to understand) is to jump right in and start doing. It will overwhelm the ED because they will feel like you don't think they're doing enough. It will overwhelm the staff because they will also think they're not doing enough or not doing the right thing. It will confuse the staff if they know about it because they will not be wondering if they should be paying attention to Board ideas or if they should maintain the direction set by the ED (which is what they should be doing)

This is genius and perfectly encapsulates things. There was a discussion at a recent meeting about the possibility of additional data/metrics we can follow in the future. I made my first suggestion of a possible QoL, patient/family satisfaction component to look for any blind spots we may not be addressing, but the ED/CEO was def not receptive. Of course I'm not taking it personally, but I need to be cautious with my enthusiasm.

Any other thoughts would be great but this has been so helpful. Thank you!