Texas Healthcare Trustees: Building Strong Hospital Boards

As the oldest trustee organization in the country, Texas Healthcare Trustees is charting the path forward in health care and hospital leadership.


When people’s health and well-being are at stake, there is no room for hesitancy or doubt in decision-making. Whether it is C-suite executives or behind-the-scenes board members, having informed and experienced leadership is paramount to ensure hospitals and health care workers are well-equipped to provide quality care to patients in need.

Ensuring those leaders have the resources they need to be successful is at the core of building strong organizations that can not only meet but exceed goals.

The Texas Healthcare Trustees (THT) does just that. THT is a statewide association comprised of Texas hospitals, health systems and the 3,000 board members who govern those organizations. The organization strives to cultivate informed leaders in health care governance and believes a knowledgeable board member means enhanced leadership, resulting in healthier communities.

“Our primary focus is providing education and resources to our Texas hospital board members to help them navigate the health care industry and make informed decisions on behalf of their community,” said Amy Eskew, president and CEO of the Texas Healthcare Trustees.

Founded in 1961, THT is the oldest stand-alone trustee organization in the country. The organization is affiliated with the Texas Hospital Association and relies on collaboration between its staff and partners to serve its members.

THT helps hospital and system leaders understand the complexities of health care and governance best practices, which leads to efficient and effective decision-making. THT does this by providing top-tier education, resources and leadership development opportunities to Texas hospital and health system trustees.

Educating and Empowering Trustees

THT offers trustees several in-person and virtual education opportunities as well as print and digital resources to cultivate a spirit of lifelong learning for its members.

Brian Jackson

“I have been blessed to provide legal advice to Texas rural hospitals for over 30 years, and one piece of advice that has never changed in that time is to actively engage with THT,” shared Brian Jackson, J.D., co-founding partner, Jackson&Carter, PLLC. “The education provided by THT is certainly valuable, but the perspective and comradery you gain from discussing rural hospital issues with other board members from all over Texas can’t be measured.”

Similar to many national governance organizations, THT’s membership resources range from a Certified Healthcare Trustee program to governance toolkits and resources, education programming and access to a network of health care leaders and professionals.

In Texas, there are no state-mandated continuing education requirements for hospital board members as there are for Texas school board members, for example. However, it is still vital that hospital board members are current on key issues impacting their hospitals. That’s why THT offers its Certified Healthcare Trustee program as a way for trustees to further their knowledge in the health care space.

“We created the Certified Healthcare Trustee program to provide board members with an organized way to get up-to-speed on health care trends, industry issues and regulatory changes, and really instill an appetite for lifelong learning among our members,” Eskew explained.

The program has proven especially beneficial for those elected board members who did not come from a health care background.

To gain their CHT certification, program participants must serve on a hospital board for a minimum of one year and complete 24 continuing education hours before passing a knowledge assessment.

Once a CHT, trustees must complete 12 continuing education hours every three years to remain in certification.

The CHT program has been a good investment for hospital leaders who understand the need for an informed governing body. CHT certifications have also helped boost hospitals’ leadership credibility for those that can say there are certified trustees leading the organization and serving the community.

No matter how far along a board member is in their health care leadership journey, THT has copious written resources to help trustees with their needs. THT provides comprehensive resources on everything related to health care governance, from a governance toolkit and a trustee guidebook to whitepapers on key topics like quality and patient safety and a quarterly Trustee Bulletin publication.

“In partnering with THA, we’re also able to connect our members with advocates working at the Capitol to gain insight on health care policy that can affect the decisions they make in the boardroom” Eskew added.

Additionally, THT offers a slew of educational webinars and in-person events for members to learn, connect and evolve their skillsets.

Susannah Ramshaw

“THT webinars cover emerging hot topics in the governance world and aim to stay at the forefront of innovating thinking in the boardroom so that our board members not only stay fresh on best practices but are also exposed to new perspectives,” said Susannah Ramshaw, former THT manager of trustee programs and engagement.

For onsite education, THT provides opportunities ranging from boardroom presentations to interact with and education board members and executive leaders to its annual conference for members.

Healthcare Governance Conference

In July, THT held its annual Healthcare Governance Conference in Fort Worth. The event welcomed over 400 members, speakers, sponsors and staff who enjoyed two-and-a-half days of governance education and networking.

“Our Healthcare Governance Conference is one of the biggest opportunities for our members to get together and network with one another while also participating in peer-to-peer learning and hearing each other’s challenges and solutions,” said Eskew.

This year’s event carried on THT’s theme throughout 2022: looking toward the future. Specifically, THT explored how the events of the past two years have implicated hospital governance positions.

Attendees heard from renowned governance expert Jamie Orlikoff who detailed a paradigm shift in governance, as well as insightful general sessions on workforce burnout and the state of play in federal politics. Other topics covered ranged from compliance, health equity and succession planning to priority issues leading up to the 88th State Legislature.

THT also held its annual Trustee Awards luncheon during the conference, celebrating three exemplary leaders in administration, advocacy and governance. And per tradition, attendees enjoyed some fresh air during the annual golf tournament. THT is already preparing for next year’s event July 20-22, at the JW Marriott Austin.

Upcoming Initiatives

As with THT’s mantra for continuing education, the organization will be continuing to provide diverse educational programming for its members across the state while also tackling a number of other projects over the next year.

“One of the bigger projects we’ll be working on over the next 12 months is overhauling our website,” said Eskew. “The site was redesigned earlier this year but now we’re working on updating content and enhancing the online resources to build a more robust online library and underscore our focus on providing accessible and affordable education to our members.”

Eskew further explained that she wants to tailor the site to their audience of board members who are busy working in hospitals, so they have more of an opportunity to self-study in a way that works best for them.

Through the end of the year, THT will be partnering with THA to conduct a five-year benchmark diversity equity and inclusion study which will look at the demographics of hospitals, hospital leadership and board members throughout the state. THT and THA plan to use the data collected to make sure their efforts are addressing the needs of Texas hospitals health care workers while also keeping community health, disparities and health equity at the forefront of the organizations’ work.

Similarly, THT will work with its Future Focus Taskforce in the upcoming months to identify program and resource needs for hospital board members around the state. The group’s charter: “Convene a group of health care leaders to discuss where they see governance and health care heading in the future.”
The task force is responsible for discussing current and future trends in health care and governance and advising THT on program areas to better anticipate and meet the needs of its members.

“The task force will be crucial to not only navigate what the future focus of THT will be, but also how that trickles down into the future focus of the various hospitals and boards who rely on THT programming and resources,” said Ramshaw.

Part of this future focus will also help THT guide conversations around the lasting effects of the pandemic and how it has altered public health, hospital operations and more.

“We’re seeing boards shifting their focus to turning the corner for their organizations and trying to figure out what’s next and how to plan for the future, given the added complexity of the pandemic,” said Eskew.

She added that THT is working to support those conversations and provide trustees with supporting information and resources for them to determine next steps and develop a strategic plan for their organizations.

Amy Eskew

Amy Eskew

“Hospital and system trustees are truly unique; often they don’t have a health care background but are tasked with leading extremely complex organizations — and they are volunteers. I feel truly fortunate to work with such a dedicated group of leaders.”

Safrat Wague

Safrat Wague
Manager, Trustee Programs and Engagement

“Having recently joined THT, I am very excited to be a part of the THT family and learn about more ways to help health care.”