Committees

Outlines:
 Introduction
 Definition of committee
 Purpose of committee

 Benefits of committee
 Committee functions
 Elements of committee
 Minutes and procedures
 Types of committees
 Hospital committees
 Individual committee members' responsibilities
 A committee chairperson's duties
 Advantages and disadvantages of committees
 Enhancement of committee effectiveness
 Role of the management committee in the organization
 References

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 Committees
Introduction
Committees have become a fact in modern organizations. The
democratic tradition in American society, the committee system's history of
success in organizations, and the legal and accrediting authority mandates
for such activity contribute to the widespread use of committee in health
care organizations. Committee participation is an expected part of the daily
routine of the chief of service, department head, or manager. The committee
structure complements the overall organizational structure, because it can be
used to overcome problems stemming from specialization and depart
mentation.

Definition of committee
A committee may be defined as a group of persons in an organization
who function collectively on an organized basis to perform administrative
activity.

A committee is a group of people who are chosen to do a particular job

or to make decision about something.

Purpose of committees:
1. To gain the advantage of group deliberation
The stimulation of shared thinking may lead to a better decision than
could be reached by an individual.

2. To offset decentralization and consolidate authority.

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 Yet, because of the limits placed on the manager's authority, not every
problem a manager faces can be solved, or every plan implemented. It is
necessary to consolidate organizational authority through specific
coordinating efforts, and committees provide an additional organizational
structure that can be used for this purpose.

3. To counterbalance authority.
To limit the action of such an individual during the transition period,
the authority of the office is stripped away and placed in a special group that
acts as a line committee in place of the official, who retains only the title and
selected symbols of office. This committee functions until the officer is
safely removed in a politically acceptable manner and a successor is chosen.

4. To provide representation of interest groups.

Occasionally, certain groups have a vested interest in an organization
and seek representation in its decision-making arenas, including committee
participation. Wanting to protect the value of their degrees, alumni of a
college seek positions on the board of trustees or on advisory committees to
specific programs.

5. To protect due process.

In disciplinary matters, an organization may seek to reflect the larger
societal value of due process, even when there is no legal or contractual
requirement to do so. An increase in litigation has added an almost legal
flavor to processes in which an individual's performance is evaluated.

6. To promote coordination and cooperation.

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 When individuals affected by a decision have participated in making
that decision, they are more likely to accept it and abide by it. Participates
in-group deliberations develop a fuller understanding of each unit's role.

7. To avoid action.
A manager who wishes to avoid or postpone an action indefinitely
may create a committee to study the question or may refer it to a panel that
has a long agenda and sends its findings to yet another committee for action.

8. To train member.
Committee participation may be used as part of the executive training
process. Exposure to multiple facets of a decision, the defense of various
positions, and the development of insight into the problems and
considerations of other manager's decision are part of this training
experience.

Benefits of committee:
1. Committees can transmit useful information in two directions toward
administrators or managers and toward employees.
2. They encourage and involve participation of interested or affected
employees in the management of the nursing enterprise.
3. Their advice can be helpful, and they can promote understanding of
objectives and programs by other employees.
4. They can promote loyalty.
5. Some of the new ideas that keep nursing an open sociotechnical system
come from committees.
6. Committees provide face-to-face meeting of individuals for the
purposes of gathering information, seeking advice, making decisions,

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 negotiating, coordinating, and thinking creativity to resolve operational
problems and improve the quality of services rendered by the
organization.
7. Committees provide a pool of people with specific skills and
knowledge that can be assimilated into plans of action.
8. They can bridge gaps between departments or units.
9. They give people an opportunity to participate in the social process of
group dynamics.
10. They can help reduce resistance to change.
11. Care quality can be improved, personnel turnover reduced, and
harmony promoted through committee work.

Committee functions:
1. Governance: In organizations considered too large for all the
members to participate in decisions affecting the organization as a
whole, a committee (such as a Board of Directors or "Executive
Committee") is given the power to make decisions, spend money, or
take actions. Some or all such powers may be limited or effectively
unlimited. For example of the latter case, the board of directors can
frequently enter into binding contracts and make decisions which once
taken or made, can't be taken back or undone under the law.

2. Coordination: Individuals from different parts of an organization (for

example, all senior vice presidents) might meet regularly to discuss
developments in their areas, review projects that cut across
organizational boundaries, talk about future options, etc. Where there is
a large committee, it is common to have smaller committees with more

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 specialized functions - for example, boards of directors of large
corporations typically have an (ongoing) audit committee, finance
committee, compensation committee, etc. Large academic conferences
are usually organized by a coordinating committee drawn from the
relevant professional body.

3. Research and recommendations: Committees are often formed to

do research and make recommendations on a potential or planned
project or change. For example, an organization considering a major
capital investment might create a temporary working committee of
several people to review options and make recommendations to upper
management or the board of directors. Such committees are typically
dissolved after issuing recommendations (often in the form of a final
report).

4. Tabling: As a means of public relations by sending sensitive,

inconvenient, or irrelevant matters to committees, organizations may
bypass, stall, or disacknowledge matters without declaring a formal
policy of inaction or indifference.

Elements of committee:

Committee terms of reference should always provide for, at a

minimum, the following elements:

1.Chairperson

2.Composition

3.Reporting responsibility (to whom and when);

4.Mandate (scope of authority);

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5.Nature of authority (report, recommend, act); and,

6.Resource and/or staff support.

Minutes and procedures:

In legal proceedings, the admissibility of committee minutes and
proceedings as evidence rest on the premise that these records were made in
the normal course of business at the time of the actions or events, or within a
reasonable time thereafter. Thus, minutes of the official business of the
organization's committees must be prepared, reviewed, and distributed in a
timely manner.

 It is common for a chairperson to organize a committee meeting through

an agenda, which is usually distributed in advance.

 The chairperson is responsible for running meetings: keeping the

discussion on the appropriate subject, recognizing members (calling on
them to speak) [often omitted in smaller committees], and calling for
votes after a debate has taken place [formal voting is normally only done
in committees involved in governance]. Governance committees often
have formal processes); other types of committees typically operate
informally, with the chairperson being responsible for deciding how
formal the committee processes will be.

 Minutes, a record of the discussion and decisions of the meeting, are

often taken by a person designated as the secretary of the committee;
they may be legally obligatory (again, typically for governance
committees, especially boards of directors).

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 For committees that meet regularly, the minutes of the most recent
meeting are often circulated to committee members before the next
meeting, and are available to the membership of the whole.

 Committees may meet on a regular basis, often weekly or yearly, or

meetings may be called irregularly as the need arises. During an
emergency, a committee may meet more than once per day, or sit in
permanent session, as, for example, (the President's Executive
Committee) did during the cuban missile crisis.

Content of minutes:
The minutes should reflect what is done, not what is said. Adequate
minutes as a matter of course contain such information as:

1. The name of committee.

2. The date, time, and place of the meeting.

3. Whether it is a regular or special meeting.

4. The names of members present.

5. The names of members absent (include a notation of excused absence

if appropriate).

6. The names of guests, including title or department as an additional

indicator of reason for attending.

The opening paragraph of the minutes, which is relatively

standardized, normally includes:
 The names of the presiding officer.

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  The establishment of quorum, if this is done routinely or at the request
of a member.

 A routine review of the minutes of the previous meeting.

Types of committees:
1- Standing committees

Standing committees, which are relatively permanent, focus on

recurring matters. The individual members change, but the committee is
continuing with respect to the number of members, the distribution of
representatives, and its basic charge.

Standing committees are advisory in authority, although some may

have collective authority to make and implement decisions. They have
continuity as organizational entities.

Typical standing committees in health care organizations include

those responsible for dealing with credentials, infection control, patient care
policies, medical records, and quality assurance.

Potential
standing Their typical roles
committees
1.Board Ensure effective board processes, structures and roles,
Development including retreat planning, committee development,
and board evaluation; sometimes includes role of
nominating committee, such as keeping list of

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 potential board members, orientation and training
2.Evaluation Ensures sound evaluation of
products/services/programs, including, e.g., outcomes,
goals, data, analysis and resulting adjustments

3.Executive Oversee operations of the board; often acts on behalf

of the board during on-demand activities that occur
between meetings, and these acts are later presented
for full board review; comprised of board chair, other
officers and/or committee chairs (or sometimes just
the officers, although this might be too small); often
performs evaluation of chief executive
4.Finance Oversees development of the budget; ensures accurate
tracking/monitoring/accountability for funds; ensures
adequate financial controls; often led by the board
treasurer; reviews major grants and associated terms
5.Fundraising Oversees development and implementation of the
Fundraising Plan; identifies and solicits funds from
external sources of support, working with the
Development Officer if available; sometimes called
Development Committee
6.Marketing Oversees development and implementation of the
Marketing Plan, including identifying potential
markets, their needs, how to meet those needs with
products/services/programs, and how to promote/sell

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 the programs
7.Personnel Guides development, review and authorization of
personnel policies and procedures; sometimes leads
evaluation of the chief Executive; sometimes assists
chief executive with leadership and management
matters

8.Product / Guides development of service delivery mechanisms;

program may include evaluation of the services; link between
development the board and the staff on program's activities
9.Promotions Promotes organization's services to the community,
and sales including generating fees for those services
10.Public Represents the organization to the community;
relations enhances the organization's image, including
communications with the press

2-Ad Hoc committees

Ad Hoc Committees are temporary committees formed to fulfill a

specific purpose and are disbanded upon achievement of the purpose.
Fuszard and Bishop use the term adhocracy to refer to the use of ad hoc
committees in nursing organizations. Applying adhocracy to nursing, a
group would be formed to accomplish a specific mission, after which it
would be dissolved. It could be called a task force, a project team, or an ad
hoc committee.

Potential Ad Hoc committees

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 The following descriptions are intended to portray various functions
often conducted by ad hoc board committees, i.e., committees that exist to
accomplish a goal and then cease to exist. Note that the following list is not
intended to suggest that all of these committees should exist; it's ultimately
up to the organization to determine which committees should exist and what
they should do.

1.Audit Plans and supports audit of a major functions, e.g.,

finances, programs or organization
2.Campaign Plans and coordinates major fundraising event;
(nonprofit) sometimes a subcommittee of the Fundraising
Committee
3.Ethics Develops and applies guidelines for ensuring ethical
behavior and resolving ethical conflicts
4.Events Plans and coordinates major events, such as
(or Programs) fundraising (nonprofits), team-building or planning;
sometimes a subcommittee of the Fundraising
Committee
5.Nominations Identifies needed board member skills, suggests
potential members and orients new members;
sometimes a subcommittee of the Board Development
Committee
6.Research Conducts specific research and/or data gathering to
make decisions about a current major function in the
organization

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Hospital committees:
There are several committees in the hospital such as:

1-Joint conference committee: Consists of the board, chief executive

officer, and medical staff representative to facilitate ongoing discussion,
provide recommendations, and review reports of chief executive officer, and
medical staff to assure the quality.

2- Executive committee: Consists of chief executive officer, some

department's heads and heads of medical staff departments, to coordinate
policies and activities of the hospital departments by reviewing their reports.

3-Quality assurance committee: Consists of medical staff

representative and heads of ancillary departments (e.g. tissue surgical
review, pharmacological review, therapeutic practice review, medical
review).It's objective is to assess the quality of medical care given, define
the problems and recommend some corrective actions.

4-Utilization review committee: Consists of chief executive officer,

some medical staff members and some representatives from medical record
department. The main objective is to assure the efficiency of using the
hospital resources and services (costs and workload).

There are many other hospital committees for different specific

objectives such as:

 Medical record committee (to review the quality of medical

record).

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  Infection control committee (to define infections cases, their
causes and how to control them).
 Credential committee (to assure the appropriate selection of
medical staff members.
 Bylaws committee (to review, update, and ensure the implementation
of medical staff bylaws.
 Blood utilization review committee (to review the utilization of
blood; determine the need for blood transfusion, and to monitor the
quality of blood transfusion).

Individual committee members' responsibilities:

Complying with the act -1
Every committee member of an incorporated association is obliged to
take all reasonable steps to ensure the association complies with its
obligations under the Act. A committee member who fails this obligation
commits an offence and is liable to prosecution and a substantial fine if
convicted. This personal obligation of committee members is a very
important one. It means that all committee members must do what is
reasonable to make sure that the obligations on the association under the
Act, such as those outlined later in this section, are complied with.

Conflicts of interest -2
Committee members must not put themselves in a position where
there is a conflict between their duties and responsibilities to the association
and their personal interests.

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 The Act requires members of the committee to disclose any direct or
indirect financial interest they may have in any contract, or proposed
contract, entered into or being considered by the committee. The disclosure
must explain the nature and extent of the interest and must be made as soon
as the member becomes aware of it. Failure to declare an interest as soon as
possible is a criminal offence and could result in a fine.

If a committee member declares a monetary interest in a contract or

proposed contract, the act also provides that:

a. the disclosure must be recorded in the minutes of the meeting; and

b. The committee member with the conflict of interest must not take part in
any committee deliberations or voting in relation to that contract. In fact,
it would be preferable if the relevant member left the room while the rest
of the committee discussed and voted on the contract.

c. A useful way to help committee members comply with these

requirements is to make "disclosures of interest" a standard item on the
committee meeting agenda. More often than not, there will be nothing to
note, but it serves as a constant reminder to members of the need to
remain aware of conflicts of interest.

Complying with the rules - 3

As noted above, the management committee is responsible for
implementing the rules of the association and ensuring that the association
meets its obligations under the act. They must comply with the rules of the
association at all times and act within those rules. While this looks to be
stating the obvious, it is unfortunately not always the case.

A committee chairperson's duties:

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 A committee chairperson's duties include arranging for logistical
support, chairing meeting, and monitoring follow up assignment .the
logistical duties include:

1- Coordinating the schedules of committee members.

2- Correlating committee activities with the work of related committees or

department.

3- Checking for compliance with mandated deadlines and actions.

4- Obtaining meeting space.

5- Issuing meeting notices as to time, date, place, and agenda.

6- Coordinating and distributing support information before meetings.

7- Preparing the agenda, including sequencing items according to priority.

Advantages of committees:
1. In addition to allowing for participation in decision-making, committee
allow for group deliberations and coordination.
2. A cohesive group reduces anxiety, curbs competitive tendencies, fosters
friendly personal relationships, and makes the group more productive.
3. Committees are used as a medium of communication. Committees
should not, however, supplant such communication techniques as
personal executive action, written communications, and individual and
conference telephone calls.
4. Meeting provides an opportunity for managers to relate to employees.
5. They provide a variety of input and a collective depth of knowledge
upon which to make quality decisions.

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6. Meeting brings together people who advance more approaches to a
problem.
7. They blend concrete experience, reflective observations, active
experiments, and abstract conceptualization.
8. Committees increase acceptance of solutions and commitment to
implementation of their decisions. In addition, groups take risks.

Disadvantages of committees:
1. Committees can waste time.
2. Committees do not always use the organization's own experience in
meaningful way.
3. Participants complain that committee meetings and conferences do not
allow enough individual input, lead to compromise, are expensive,
sometimes have weak leaders who are dominated by other members
and act as substitutes for weak executives who cannot make decisions.
4. If not trained committee participants may arrive at premature
decisions, especially those that are popular with a majority of
members.
5. Without trained leadership, committees can be dominated by one
person, suffer disruptive conflicts, and be tormented by individuals
who must win at all costs.

Enhancement of committee effectiveness:

Committee, in spite of their limitations is valuable for organizational
deliberation. Their effectiveness may be enhanced by:

1. Viewing committee activity as important and legitimate.

2. Providing the necessary logistical support.

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 3. Assigning clear responsibilities and specific functions to the
committee.
4. Considering committee size, composition, and selection of members
carefully.
5. Maintaining adequate documentation and follow up activity.
6. Creating task forces as an alternative to the proliferation of committee.
7. Ensuring that members are sensitive to group dynamics and
organizational conflict.
Role of the management committee in the organization:
The management committee plays an important role in the
organization as both leaders and decision-makers. Their overall
responsibilities are summarized below.  Use the links provided to access
more information on each topic:

1-Vision and leadership

The management committee ensures that everything the organization

does supports its vision, purpose and aims. They establish the fundamental
values, the ethical principles and strategic direction in which the
organization operates.

2-Accountability

The management committee must account for everything the

organization does, including its spending and activities. The management
committee is accountable to the membership of the organization and other
key stakeholders such as funders and donors. The management committee
monitors and evaluates all areas of the organization's performance.

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3-Keeping it legal

The management committee ensures compliance with all relevant legal

and regulatory requirements and seeks guidance around any uncertainties.
Everything the management committee and the organization do must also be
in line with its governing document, e.g. constitution or memorandum and
articles of association.

4-Financial oversight

The management committee ensures that all money, property and

resources are properly used, managed and accounted for. In order to be
accountable, suitable systems must be in place and kept up to date.

5-Managing staff and volunteers

In organizations that employee staff, the management committee is

essentially the employer. They must ensure that appropriate policies and
procedures are in place for staff and for volunteers, and that both are
properly managed and supported. The management committee, usually
represented by the chairperson, also directly line manages the most senior
staff member.

References
 Swansburg.R & Swansburg.R(1999); Introductory Management and
leadership for Nurses,p393-413

 Liebler.J & McConnell (2008); management principles for health

professionals, committee and teams, p 311-344

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