Individualized Board Leadership Retreats

The governing board of a hospital serves as the bridge between operational management and the community. In the current environment of national healthcare transformation, boards have expanding responsibilities to ensure that the hospital remains viable while meeting new and increasing responsibilities to the community for quality of care and overall health of the population.  As a result, new strategies and even responsibilities for the board are developing to oversee the value the hospital brings to the community and adjust to new payment models, partnerships, and technology adoption to sustain the organization.


Fourth Aim brings facilitation skills to any governing board that realizes the need to address challenges of the Affordable Care Act and current healthcare environment. Fourth Aim provides a framework to lead governing boards to a new level of strategic thinking that supports innovation approaches to care, improved performance measurement and use, and alignment with community initiatives to achieve high performance healthcare.

Orientation of New Critical Access Hospital CEO

While there are a number of healthcare managers that have excellent leadership potential, many of them have limited experience in CAH facilities with cost based and other unique financial reimbursements. 

Fourth Aim provides support to such leaders in transition from the perspective of a successful CAH administrator on the nuances of CAH financial systems, advantage of these processes in developing new clinical product lines, and developing increased awareness of the pitfalls of cost based reimbursement. Coaching support for the new executive can allow a board to pick a high potential leadership candidate that has not had the previous CAH experience..

Interim Leadership

Smaller rural facilities do not routinely use interim leadership during chief executive transitions.  Recognizing that interim leadership, when done well can provide not only a temporary executive, but a fresh set of eyes to evaluate current operational strengths and opportunities of the organization, Fourth Aim strives to provide a cost competitive solution for smaller facilities and critical access hospitals. 


Interim leadership provides stabilization during the search and selection process and leads to an increase in the speed of transition for the new executive. Interim leadership does not preclude consideration of internal candidates, but provides a process of transition to consider the best leadership option to meet the needs of the hospital.  Fourth Aim interim leadership includes a transition style briefing for the new executive and administrative team to reduce the orientation time and identify high priority areas needing immediate support. 

Fourth Aim includes planning and operational evaluation support as part of the interim role, which is typically provided by a separate consulting service.