The following perspective from ACC President Richard A. Chazal, MD, FACC and Governance Committee Chair Athena Poppas, MD, FACC provides insight into the progress and recent accomplishments of ACC’s governance transformation process, as well as what discussions and changes are anticipated to come in 2017.

Refining Leadership Competencies and Employing Them in BOT Nominations
The final two Board of Trustees meetings of 2016 included extensive discussion around elements of ACC’s governance transformation. The October Board meeting included a review and discussion of the key findings of the recent BOT Prioritization Skillset Survey, which was conducted this past summer in order to validate the Governance Committee’s work around Leadership Competencies to date and explore potential leadership and strategic mindset gaps. The assessment included inquiries regarding both leadership and technical skills needed from the Board’s perspective. This survey feedback provided critical insight, while also served as a strategic opportunity to address the needs of our members today, and well into the future.

The Governance Committee has been working diligently to operationalize the 11 Board-approved Governance Principles that will help guide ACC as it becomes an increasingly nimble, strategic organization. While committee members continue to make significant progress on behalf of the College, they also recognize that certain elements of the new framework require iterative refinement and implementation to ensure cohesive awareness and adoption. One of those elements is the Leadership Competency model, specifically called out in Principle 10.  The Leadership Model ensures transparency for those that wish to grow further within the College, while also providing a shared language to do such. As this is a significant shift, the College intentionally launched this effort at the Board level in order to test the model within a distinct control group. In doing such, the Nominating Committee recently leveraged the Leadership Competency model and supporting tools as a strategic component during ACC's recent BOT and officer selection process. It is not to suggest that each individual must be savvy in each area of the model at all times.  Rather, it is designed with the intention that the composition of the Board is reflective of the Leadership Competencies en masse. We expect the competency-related detail to evolve alongside stakeholder feedback / input / environmental shifts.  Leveraging the Nominating Committee to provide real-time feedback in this regard is an example of such, and vetting this with the BOT was critical in getting to this stage.

The Nominating Committee leveraged the Leadership Competencies to help guide the process in late November and presented their recommendations at the BOT meeting in early December. Following a detailed review, the BOT eagerly recommended the College’s new slate of officers, trustees and committee leaders put forward by the ACC’s Nominating Committee. Cathie Biga, MSN, RN was recommended to serve on the BOT from 2017 – 2020, and Paul Casale, MD, FACC and Robert C. Hendel, MD, FACC were reappointed to their positions and will serve through 2020. The BOT was also informed of the nomination of Andrew P. Miller, MD, FACC as chair-elect of the ACC Board of Governors to serve from 2017-2018. The College is grateful for the outstanding contributions of three Trustees whose terms will end in 2017, including Thad Waites, MD, FACC, Jane W. Newburger, MD, MPH, FACC, and Debra Ness, MS, who served as a public member of the BOT.

Operationalizing Centralized Authority and Decentralized Decision-Making
Further governance discussions at the October BOT meeting included a session on strategy vs. tactics and how College activities will be overseen under the new governance principles, as well as work to understand and refine the “authority matrix” that details roles and responsibilities of College leaders and governing bodies.  At the December 3-4 BOT meeting in Washington, DC, Governance Committee Chair Athena Poppas, MD, FACC presented the proposed Authority Matrix. The document clarifies how the concept of "centralized authority and decentralized decision-making" is to be operationalized. It is important to note that the College assumes broad communication and input from key stake holders, and  the authority matrix outlines those high-level actions that must be taken. The key elements of the Authority Matrix focus on assigning the authority or responsibility to do the following: Approve (initiate, review and either adopt, amend, disapprove or send back for further consideration); Recommend (Initiate action for consideration or a decision); Consult (Must be sought for advice or information before a decision); or Inform (Must be informed of action after a decision and before distribution). Much time was spent reviewing and discussing the document and the BOT provided recommendations for minor modifications to the Governance Committee. The Authority Matrix was approved and finalized prior to the January BOT meeting and the document is available here on ACC.org. Issues, particularly around decentralized decision-making, are complex and mandate careful and evolutionary integration into College activities.  While some areas of ACC are currently in an excellent position to assume these roles, others will take time to develop.

What’s Next for Governance in 2017?
The BOT met on Jan. 28 and 29 in Orlando in concert with the CV Summit and Leadership Forum, and governance was on the agenda. The Governance Committee is currently working on a large initiative focused on the ACC’s Council and Committee Charters to help operationalize the decentralized decision-making model. With this effort, Councils and Committees are working to revisit their current charges and/or create a Charter to ensure uniformity, transparency and guidance for our member leader groups. The Governance Committee has also been reviewing member leadership development with the goal of ensuring all newly appointed member leaders receive robust orientation and onboarding that will best prepare the ACC’s leaders for their roles.  In concert with the Board, and in keeping with the diverse needs of our membership, the Governance Committee looks forward to further operationalizing the Governance Principles in support of advancing the mission of the College.  

Keywords: Committee Membership, Decision Making, Goals, Governing Board, Leadership, Trustees

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