title: Expanding a Canadian community health centre.
abstract: OBJECTIVE
  The current study's purpose is to examine, through a case study, a community health centre board's governance during an expansion period with particular attention to the organizational and internal board relations that contribute to or inhibit expansion.
  
  
  METHODS
  All board members on the slate during the expansion were invited to participate in one semi-structured interview. Administrative data (board documentation and correspondence) were also used to inform the study. Discourse analysis was used to analyze the data.
  
  
  RESULTS
  While board members agreed with the expansion they acknowledge that the expansion process should be examined. Board members identified missing board skill sets, comfort with governance and low organizational understanding as personal barriers to an enhanced process. External barriers included: absent decision support tools; documentation and information availability and historical decision making processes.
  
  
  CONCLUSIONS
  Half the board members agreed to participate in the interviews. Of those declining, 30 percent cited difficulties during the expansion period as their rationale for withdrawing.
  
  
  CONCLUSIONS
  Findings add to: the limited publications regarding primary healthcare service expansion; and understanding expansion and volunteer board members' roles and their governance process during this time.
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Canada.
authors.forename: Stacy
authors.initials: S
authors.lastname: T Greening
authors.forename: Cameron
authors.initials: C
authors.lastname: Wild
authors.forename: Vera
authors.initials: V
authors.lastname: Caine
mesh_terms: D000416:Alberta; D003151:Community Health Centers / Q000458:organization & administration*; D017598:Efficiency, Organizational; D006075:Governing Board; D006276:Health Facility Size; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D012189:Retrospective Studies
keywords: Governance; Organisational development; Organisational effectiveness; Process management; Quality healthcare