Fagan Uses Her Marathon Runner’s Determination to Guide AACVPR
Believe it or not, running a marathon and running a board of directors have a lot in common. Just ask Barbra Fagan.

Fagan is president of the board of directors of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), a 3,000-member association of physicians, nurses and healthcare professionals that serves the field of cardiac and pulmonary rehabilitation. In her spare time, she has ran in more than 50 marathons. She also competes in triathlons all over the country. Fagan is currently training for her 14th, which she will participate in later this summer. She has even run a 100-mile race. Yes, 100 miles, without stopping. It took her 26 hours to finish, but she finished.

“You just keep moving forward,” she said, explaining her incredible feat of endurance.

Discipline, Focus and Determination

She sees clear parallels between running a race and running a board. Discipline, focus, determination, consistency, perseverance and self-direction are all traits that apply to both activities. “It is a commitment to excellence,” she said. “[The board] is committed to serve our members and the patients our members serve. It is about staying in tuned to what is critical and not paying attention to the things on the periphery that can distract you from your mission. And obviously, it is about pure enthusiasm and love for what we do.”

Fagan, the workforce health director of business development at Froedtert & The Medical College of Wisconsin, Menomonee Falls, Wis., has been a member of AACVPR since 1987. She joined as a clinical exercise physiologist in cardiac rehab and moved up the leadership ladder in both her career and the association. Her rehab program received national recognition as an innovative approach, and she routinely spoke about it at meetings. She got involved in the state affiliate of AACVPR, the Wisconsin Society of Cardiovascular and Pulmonary Rehabilitation, and rose to the rank of president. She also sat on the outcomes committee for the national organization. Then, in 2008, she was approached about becoming a member of the national AACVPR board. “Quite honestly, I was humbled,” she said. “When you think of a board, especially when you are younger, you think of this group of people you could only aspire to be.” But her rise continued. Shortly after joining the board in 2008, she was appointed to the executive committee and, in 2013, was named president for the 2013-14 term.

Since 2008, Fagan has seen quite a positive change within the board and the organization — a transformation she supported as a member and then as president. “How did I perceive the culture of the board when I started? Very different than how I feel it is today.”

Clearly Defined Roles

Fagan joined a board that included very bright, intelligent, highly capable people who all had the singular focus to better the organization and serve its mission. “The biggest difference I see between then and now is back then was that the staff and the board seemed to operate more parallel to each other, as two separate entities,” she said. The roles and responsibilities of each were not clearly defined, so the board had its hands on a lot of things, “Now, I see the two operating more synergistically, as one unit.” Instead of focusing on everything, the board concentrates on doing a few things really well.

That is by design, of course, thanks to Fagan's vision. “Just like anything else, when you can do something together, you are going to have a much better outcome in the end. We are all on the boat together and rowing in one direction. It has been outstanding to watch this board evolve.”

The transformation started with her predecessor, Anne Gavic, who served as president from 2012-13. “She was instrumental in laying the foundation,” Fagan said. “She is 100 percent responsible for having the courage to create a strong strategic plan – the bedrock for success. She made it easier for me. I walked into a situation where we had a strategic plan and could start to streamline the way the board functions.”

Under Fagan's leadership, the board has become more efficient. By establishing trust and a good working relationship with the executive director, Megan Cohen, and the staff, the board no longer spends time overseeing staff and day-to-day functions. “I believe the board president simply is the conductor of an amazing orchestra where everyone is doing their part,” she said.

For its part, the board is now more externally focused, honing in on the big picture – the strategic plan, not minor matters. By focusing on what is important and not things the staff can and should manage, the in-person board meetings are shorter and focus on outcomes and making strategic decisions. Committees still present their findings but not during meetings unless board action is required. There is no micro-managing, just a lot of trust in good people doing their jobs. “You trust your committee members to do the work and bring it up to the board when they need decisions.” As a result, the board meetings, which used to last two full days and go into the night, are now finished in less than a day. However, one thing the board members do spend more time on is governance training — at least an hour or two every meeting — to continuously learn more about what their roles should be as board members.

Fantastic Year

The governance shift has indeed translated into success for the organization. “When everyone does their job and we all have that commitment to excellence, really cool things happen,” Fagan said. It has been been “a fantastic year” for AACVPR. “Membership is the highest it has ever been, revenue is up and we had record attendance at our annual meeting.”

For the first time, AACVPR launched a virtual component to the annual meeting so people could attend remotely. It is an example of big-picture thinking coming to fruition. “In the past, the board was more fearful of making those kinds of decisions,” Fagan explained. “But you have to take risks, and the culture we have now enables us to take risks and be innovative.”

In the past, there was indecision at times because everyone had to agree on an idea to move forward. Now, it is different. The board still vigorously debates ideas, but because of the focus on outcomes, ultimately it speaks with one voice. “Everyone has a voice, and you may disagree sometimes, but when we walk out of the room, we are a unified board. We come to a decision, a vote and then we are unified. That is important.”

With such momentum, the board has taken steps to make sure it continues. “It takes time to create a really good strong culture, but it takes just a moment to lose it,” she said. That is why the board is currently developing a culture statement, one that will define the culture of the board for future members. Candidates not only will need the experience and knowledge, but they also have to fit into the culture. “That is one of the characteristics you look for when putting new members on the board.”

With a strategic plan and an established culture in place, Fagan is confident AACVPR will continue to be well positioned for continued success. “Every board member has contributed to our success and, like training for a race, you get out of it, what you put into it,” she said.

Spoken like a true marathoner.


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