Students in this course will apply the Pillars of Excellence model (quality/safety, finance, growth, patient experience, and workforce engagement) to leadership and governance of highly reliable healthcare organizations. Students will assess governance structures and performance outcomes for alignment with mission, vision, values, and goals. The impact of changing regulatory policies and marketplace dynamics on healthcare organizational governance and structures is discussed. Students will examine the influence of legal structures on governance systems and organizational design. The relationships between governing bodies, facility operations, and executive management are explored. Students will apply concepts of the Virtuous Business Model to the governance of highly reliable healthcare organizations.