Mike Abrams knows how easy it is for a board to lose focus during its periodic in-person meetings. To keep his board on track, Abrams, CEO of the Ohio Hospital Association (OHA), uses a variation on the 80/20 rule, which famously says that 80 percent of a team’s results comes from 20 percent of its effort.

In a similar vein, “we say that 80 percent of our board’s time should be spent discussing issues of strategic importance to the membership,” he says. “That means [only] 20 percent of the time should be devoted to the organization’s financials and other association business items.”

Without such a guiding principle, board members risk running down “rabbit holes,” says Paul Preziotti, principal at Johnson Lambert, LLP. In his role as audit chair on a nonprofit board, he tailors financial reports that are easily digestible in five minutes or less.

“When you present a statement of activity with 30 line items, chances are someone will have a question,” he says. “Too much information and too many micro-level details can make board meetings go bad.”

Too much information and too many micro-level details can make board meetings go bad.
— Paul Preziotti

Here are three ways Abrams gets his board ready for strategic thinking at their five four-hour meetings each year.

Homework. Between meetings, OHA board members are expected to complete homework assignments, which are spelled out in the board packet. “[Homework] might be: Discuss with your CFO this issue we’re bringing to the board that has a significant economic impact on Ohio hospitals,” Abrams says. “Or it might be: Check with your chief medical officer—the highest-ranking physician in your system—about the opioid issue and what’s going on in your ER department.” Each board member is expected to share their findings.

Discussion leaders. Before each meeting, Abrams appoints one to three board members to drive the discussion. “You want to make sure everyone feels comfortable with the discussion, and we don’t have that awkward moment, where everyone’s looking at each other saying, ‘OK, who’s first?’”

Agenda structure. OHA’s board has established three strategic initiatives: advocacy, economic sustainability, and healthcare quality/patient safety. Each meeting agenda lists those key initiatives as topic areas for discussion, and agenda items are organized accordingly. “It helps to bake in our strategic plan into our routine agenda,” Abram says. “Our board members are now used to seeing those three initiatives, which give shape to each agenda, and it helps us stay focused.”

If you’re not conscientious about managing how your board spends its meeting time, you risk volunteer churn, Abrams says: “You might lose people who might otherwise make a good contribution.”