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This questionnaire is designed to assist board members of public sector organizations to examine their approaches to governance and identify areas of consensus related to their organization and the challenges that it faces. The questionnaire will only take a few minutes to complete. Replies will remain completely anonymous and confidential. For the survey to be effective, it should be completed by all current members of the Board of Directors. Your responses should be received no later than (specific date). This will enable us to analyse the findings prior to the (board retreat/next meeting/etc.) (If you are unsure, or feel you do not have enough information to answer any question, simply leave that item blank) The following questionnaire is for viewing and information purposes only. If you would like a copy of the questionnaire, please click here to download the Microsoft Word document.
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| 1. | First, please rate the following aspects of your board's ongoing operations: | ||||
| Excellent | Good | Fair | Poor | ||
| a. | Degree of organization at board meetings | ![]() |
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| b. | Level of participation by members | ![]() |
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| c. | Clarity of board and staff roles | ![]() |
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| d. | Board member access to relevant information | ![]() |
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| e. | Staff support | ![]() |
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| 2. | Think now of your own involvement with the Board of Directors, and indicate your level of agreement or disagreement with each of the following statements: | ||||
| Strongly Agree |
Somewhat Agree |
Somewhat Disagree |
Strongly Disagree |
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| a. | The board is dealing with important issues | ![]() |
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| b. | The board has a hard time focusing on issues | ![]() |
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| c. | We spend too much time discussing things that have nothing to do with the agenda | ![]() |
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| d. | We have many good discussions and debates on this board | ![]() |
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| e. | The board seems to have a hard time making decisions | ![]() |
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| f. | Board members represent a variety of philosophical perspectives | ![]() |
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| g. | The members of this board work well together | ![]() |
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| h. | There is a clear distinction between board and chief executive roles | ![]() |
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| i. | I feel quite comfortable in "speaking my mind" at board meetings | ![]() |
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| j. | Some members tend to dominate board meetings | ![]() |
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| k. | I believe that my comments are respected by others | ![]() |
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| l. | Some board members spend too much time representing the interests of specific regions | ![]() |
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| m. | We tend to deal with a lot of issues that are outside our mandate | ![]() |
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| n. | I believe that I make an important contribution to this board | ![]() |
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| o. | I believe that this board makes an important contribution to the mandate of the organization | ![]() |
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| 3. | What do you feel is the single most important strength of this board? | ||||
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_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ |
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| 4. |
List below what you feel are the three main obstacles interfering with board performance:
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| 5. | This question pertains to the role of the board. For each item, Column 1 asks you to agree or disagree with a statement about what the role of the board should be. Column 2 asks you to indicate how your board actually behaves. For each item, circle the numbers which most closely correspond to your view:
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| We should do this |
We actually do this |
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| a. | Keeping up with relevant trends, events and emerging issues | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| b. | Establishing strategic directions for the organization | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| c. | Ensuring the needs of our customers are addressed | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| d. | Providing advice to management on service priorities | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| e. | Providing advice to management on human resource issues | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| f. | Influencing social policy | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| g. | Communicating with the public and specific stakeholder groups | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| h. | Overseeing financial matters | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| i. | Overseeing operational matters | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| j. | Evaluating health services | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| k. | Lobbying for more resources | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| l. | Establishing community linkages | 4 | 3 | 2 | 1 | 4 | 3 | 2 | 1 | |||||||||
| 6. | Any there any other important roles that should be carried out by the Board of Directors? | ||||
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_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
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| This next series of questions deals with your perceptions of the organization and some of the challenges that it faces in the next few years. | |||||
| 7. | First, how would you rate the your organization's overall effectiveness?
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Very effective
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Not very effective
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| 8. | Please list one major strength and one major weakness of your organization: Strength: _________________________________________________________ Weakness: _______________________________________________________
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| 9. | Please list one opportunity and one threat facing your organization: Opportunity: ______________________________________________________ Threat: __________________________________________________________
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| 10. | What do you feel are three most significant external challenges confronting your
organization in the next year?
(List them in order of priority)
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| 11. | Are there any other important trends, issues or events that the board should be considering? | ||||
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_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
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| 12. | Feel free to make any other comments or suggestions to assist in future board planning and development initiatives: | ||||
_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
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Completed by:________________________________________________________ (Necessary only for follow-up with non-respondents) Please return the questionnaire by mail, fax or email to______________________ at the address below: Thank you for your cooperation.
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