Transforming Des Moines University

A Case Study in Integral Leadership

By Angela L. Walker Franklin    //    Volume 31,  Number 6   //    November/December 2023

  • Focus on the relationship between the board and the president. Build trust by establishing strong communication channels early, including initiating regular board meetings with executive leaders.
  • Seek external guidance. Invite outside experts to provide counsel on best practices for governing boards. This helps the board and the president gain new perspectives and insights, leading to more effective decision-making and collaboration.
  • Establish board accountability measures. Consistent processes can help set expectations and maintain high performance and engagement among board members.

“Whether an institution is public or private, large or small, four-year or two-year, the compelling need is for chief executives who can demonstrate integral leadership.”

In 2006, the Association of Governing Boards Task Force on the State of the Presidency in American Higher Education defined integral leadership as a president exerting “…a presence that is purposeful and consultative, deliberative yet decisive, and capable of course corrections as new challenges emerge. Integral leadership succeeds in fulfilling the multiple, disparate strands of presidential responsibility and conceives of these responsibilities as parts of a coherent whole. Leadership of this sort links the president, the faculty, and the board together in a well-functioning partnership purposefully devoted to a well-defined, broadly affirmed institutional vision”1

I proudly serve as the 15th president and CEO of Des Moines University (DMU), a 125-year-old medicine and health sciences university steeped in the tradition of excellence, compassion, and patient-centered health care. When I arrived as a new president at DMU in March 2011, I immediately sought out resources and guidance from AGB. And thanks to the leadership of DMU’s Board of Trustees, an AGB consultant was engaged early on to assist in onboarding me as the new president and to begin the much-needed transition of the board to embrace and follow best practices, including a commitment to integral leadership.

I am forever grateful to the board leadership for their guidance in taking the first step in the transformation of DMU when they offered me the opportunity to join them as president and CEO. Now, 12 years later, we can share our story of developing a well-integrated and well-functioning partnership that reflects the basic tenets of AGB’s philosophy of integral leadership.

An Evolutionary Arc

Founded in 1898 as the nation’s second college of osteopathic medicine, Des Moines University is again in a pioneering position as it fulfills a bold plan to deliver a new campus on 88 acres—four times the size of its previous footprint—in West Des Moines, Iowa. This exceptional endeavor tells of a visionary and disciplined board of trustees that, in the words of former chair Larry Baker, doctor of osteopathic medicine and Fellow of the American College of Emergency Physicians, “could not have been possible under our old ways.”

Since 2011, DMU’s Board of Trustees has been on an evolutionary arc that has been transformative for its leadership and governance of the university. Before my arrival, in a prescient move, certain board members began discussing how to enhance the board’s governance and accountability and drive the institution’s vision by thinking in new ways about the future. Until then, the board had an acceptable record of basic management of the university. Beginning in about 2010, as they recruited a new leader, members knew significant change was needed to provide sustainable competitiveness. They also knew it was also necessary to preserve the board’s fiscal integrity, shared governance, institutional effectiveness, and commitment to embedding diversity, equity, and inclusion (DEI) principles deeper into the culture and curriculum and to develop an energized strategic planning process.

Dr. Baker, a 1977 DMU alumnus, has said the principal catalyst was finding a visionary, bold president who would commit to the long term and apply innovative thinking and processes to advance the university.

When I arrived as the newly selected president in 2011, the membership of the DMU board began to think differently. It has since been steadily reconstituted into a more diverse, vibrant, nimble, and strategically minded body.

Commitment to a Different President

A part of the board’s governance exploration was an agreement to seek a president with fresh perspectives—and even a different career path than they might earlier have felt comfortable inviting to Des Moines. In short, they wanted a president who would challenge them. Now, 12 years later, it is evident that we, together, have committed to the future of this university in ways that no one previously could have imagined.

Shortly after my arrival, I was challenged to explore the university’s culture while working collaboratively with board leadership to begin embracing best practices. The DMU Board of Trustees was ready. Board members already had started asking self-reflective questions about how the board should operate, what its focus needed to be, and how it could best support the university’s growth to ensure a sustainable future. Board members sought to do this at a time when higher education was again negotiating public perceptions of relevance and value, and all institutions were feeling increased pressure to distinguish competitive value.

Changing Member Recruitment

In one instance, the simple question of how to recruit new board members was raised. That “elephant-in-the-room” moment was a spark that forever changed the trajectory of the university’s board construct. In 2012, the majority (more than 50 percent) of the board was composed of graduates, most specifically, those in DMU’s core Doctor of Osteopathic Medicine program. The discussion quickly evolved to acknowledge the need to have diverse minds around the table: doctors of osteopathic medicine as well as accountants and business leaders, non-physician members from different industry sectors to offer new perspectives, and so on.

“Ideally, each member needs to be multitalented—we need to bring our differences to the benefit of all,” Dr. Baker advised at the time.

Embracing Bold Change

I arrived at DMU as the first African American female leader of a free-standing medicine and health sciences institution. I am a clinical psychologist. I accepted the challenge head-on. Within a few short months, I presented detailed, unvarnished findings and recommendations to the board. Some of my recommendations were quite bold and, at the time, a bit tough to swallow. With considerable angst, I presented the board with a 100-Day Presidential Report in May 2011. According to Dr. Baker, every member in the room applauded the comprehensive assessment, courage, and leadership acumen.

In that moment, board members could not have realized that they had turned a critical corner and were writing their future of new thinking and of a commitment to DMU’s extraordinary journey. This milestone moment was bound to have enormous impacts on the landscape of higher education and the medicine and health sciences.

Ultimately, board members agreed to take the lead. They embraced best practices, holding their own “feet to the fire” by engaging outside counsel to jump-start the change process.

“We adopted and practiced much-needed humility to open ourselves to new ways of thinking and leading,” Dr. Baker reflected. “The board saw ways it could improve its internal communications, provide the guidance needed, and take renewed personal and collective responsibility for the fiduciary charge it was responsible for managing.”

Personal Reflections

I grew up in a household that emphasized living by the Golden Rule. Over the years, I have ascribed to a philosophy of leadership that comes close to the principles of servant leadership. I have an engaged, collaborative approach to leadership that allows one to “serve” and not “be served.” I am very hands-on. I believe in the power of the personal touch. And I am a good listener thanks to my training as a psychologist.

I came to DMU without fully understanding the culture and “wounds” from the past. This organization had long-standing issues of leadership distrust and a divisive “us vs. them” mentality. I was charged with evaluating the current environment and creating a pathway and vision for the future. My assessments led to questions about leadership, and ultimately, I made a decision to restructure the organization. Although I firmly believe this was the right choice, it was not without its challenges. A few board and faculty members were unhappy with the personnel decisions and resigned. The removal of certain team members also raised questions about my intentions throughout campus, but unfortunately, I could not address these concerns due to confidentiality constraints.

I worked tirelessly on my relationship with the board, keeping them informed of every step. The board’s leadership gave me the latitude to make the needed changes. Thankfully, there was “trust” that I would do the right thing. For that, I am grateful. Without that, I probably would not have sustained the challenges created by these changes on campus.

The first few challenges of my leadership allowed trust to build within my relationship with the board. The basic premises were to never “blindside” the board, keep members informed, and bring them along my journey of discovery and strife as I learned of the challenges within the organization.

Focus on Board Culture

Several priorities, among other board-initiated concerns, became the focus of institutional actions needed to create a more certain future for DMU. The board’s impact can be illustrated through its decision-making and support of recommended actions in these exemplary instances of willingly embracing change:

  • Local retreats. Beginning with the first annual board retreat in March 2011, I asked about the value of the annual “spring break” meeting that was typically held in sunny climes such as Florida or Arizona. After posing the direct question about the value and purpose of such costly trips, and to the board leadership’s credit, the members agreed it would be more prudent to make better use of time and resources. Today, board retreats are local, rich, and challenging two-day work sessions that focus on best practices of board operations and decision-making. They consider means for expanding principles of DEI across campus, philanthropic priorities, curricular and co-curricular expansion and change, campus master planning, and more.
  • Accountability measures. Before 2013, there were no term limits for members and no self-evaluations—there were virtually no member accountability measures. These are now well-established, regular, vital routines central to the board’s business. Furthermore, in 2013, the board instituted 360-degree evaluations for all members and asked the governance committee to look into issues that would arise through the process. This process encouraged the board to invite new talent to join.
  • Monthly meetings. To tighten the communications network and build trust, the board instituted monthly meetings among the president, board chair, past chair, and vice chair.
  • External guidance. Unlike in the past, the board now routinely invites outside specialists to provide guidance and counseling on best practices for governing boards.
  • Widening mission. The board realized that to expand the research enterprise, DMU would need to think more broadly about its fundraising mission, obtain supplemental external funding, and widen the aperture of its research portfolio. In short, the DMU board responded to the call to think differently about its purpose, responsibility, and market opportunities.
  • Philanthropic support. The role of board members taking leadership gift positions with time, talent, or treasure, while new for some, became a central, recurring theme.
  • Strategic plan approval. The board is now involved in approving each three-year strategic planning and visioning cycle for the university.
  • Enrollment management. The board approved the adoption of a formal strategic enrollment management process that involved the engagement of a consultant to create the framework. Unlike in the past, the metrics of that process now constitute regular reports to the board.
  • Brand strategy. The board also supported advancing the university’s brand by investing in an integrated and renewed marketing and brand strategy.
  • Supportive environment. The board worked to stabilize the institution’s culture to be more supportive and collaborative and to eliminate destructive back-channel politics. This process involved giving full support to the president for removing problematic high-level employees and making a structural change in the university’s top administration.
  • Shared governance. The board brought to life shared governance practices by inviting university constituents to be involved in various aspects of board meetings and deliberations.
  • Member recruitment. The board agreed to change its member recruitment screening and selection process to be more strategic and responsible, with a leading interest in diversity of background and experience.
  • Member training. The board upgraded the orientation of new board members to be more comprehensive. The board also focused on digital competency. In recognition of its expanded national representation and to ensure smooth operations and facilitate communications among members remotely, the board adopted a board portal management platform in 2017. That required additional investment of time to learn the platform intricacies and new communications modalities.

“Think of the horsepower you now have in this room,” was the telling aside Dr. Baker whispered to me in 2016 as he acknowledged the fast-changing board construct.

At this stage, the collective effort was finally making a difference.

Critical Shift in Philanthropic and Alumni Engagement

Historically, DMU has operated without expecting philanthropic support from its board members. While DMU continues to be tuition-dependent, the university has broadened its financial horizons by actively engaging in philanthropic endeavors. This shift has diversified DMU’s funding streams and fostered a culture of giving at the university.

After my arrival, I advised the board to consider their role as chief fundraisers and ambassadors for the university. I also recommended that we commit to restructuring the institutional advancement function.

The board approved my plans, rose to the challenge to become donors, and began applying newly learned skills in philanthropy—also learned during special facilitated sessions held during March retreats. Their newly found excitement in the ambassadorial process is a primary reason for the anticipated success of DMU’s $50 million Purple & Proud capital campaign, the largest fundraising campaign in the university’s history.

“When we all heard the plan for the move to a new campus, there was a split second of deafening silence and then an explosion of applause with every board member on their feet,” said Dave Kapaska, DO, MBA, Des Moines University’s current board chair, and a 1986 alumnus. “That lightning bolt moment underscored we had indeed changed.”

As it elevated fundraising priorities, the board also became instrumental in helping substantially increase the level of alumni engagement nationwide. In 2010, alumni engagement (of any type) stood in the single digits. In 2022, the Office of University Advancement reported an alumni engagement rate of 23 percent.

Ultimate Benefits of Board Evolution: Building a New Campus and Campaign

The tangible results of the renewed board direction can be seen mainly in two large-scale, emblematic dimensions. These are the imminent completion of the $50 million fundraising campaign and the unanimous board endorsement for constructing a $260 million campus in West Des Moines.

“By putting our unanimous faith in the remarkable leadership skills of President Angela Franklin, we, the board, demonstrated that we could make bold and difficult decisions and challenge ourselves in the process,” said Michael Witte, DO, Des Moines University’s past board chair, and a 1977 alumnus who oversaw the approval of the new campus project. “That is what high-performing governing bodies need to do. Ten years ago, this university could not have succeeded in a capital campaign nor conceived of the extraordinary vision to create a new campus on a tract of farmland.”

Concluding Thoughts

The leadership team of DMU—and by extension, the entire campus community—is extremely proud of the membership, attitude, style, and passion of every member of today’s DMU Board of Trustees.

The Des Moines University Board of Trustees has evolved to provide the exemplary leadership needed to guide an institution through challenging transitions to forge leadership stability and sustain fiduciary responsibility. Such stability and visionary leadership factored large in the Higher Learning Commission’s ten-year reaccreditation of DMU in 2021, securing its excellent standing for the next cycle.

The board also has improved its effectiveness through structured self-assessment practices and is appropriately involved in supporting the comprehensive institutional strategic planning process. Understanding its responsibility to ensure the safekeeping and prosperity of DMU as a dynamic institution for the state of Iowa, the Midwest region, and the nation, the board has provided bold and focused direction during a much-needed leadership transition.

Overall, board actions during recent years demonstrate the value of a commitment to selfless leadership and passion for the institution’s mission that began 125 years ago.

The culmination of my 12 years of advancement and evolving to embrace best practices has led to the realization of a dream campus on 88 acres of land, allowing us to reimagine medicine and health sciences education and develop an enterprise steeped in the tradition of excellence, compassion, and patient-centered care.

I was honored in September 2022 when the board announced the naming of a street on DMU’s new campus to be called Franklin Way, thanking me for my leadership, vision, and service. While it’s nice to have a permanent marker like this, what was more valuable was the board’s recognition of the work we have done together to “reach far, dream colossal dreams, and set audacious goals.” I said these words during my presidential inaugural address—and they have carried us through our work all these years.

At the street naming ceremony, Dr. Kapaska said, “President Franklin, may this sign forever inspire others to follow your example by finding ways to serve, lead, and make health care and public health better for all people. And may your leadership and vision inspire all of us—DMU alumni, friends, employees, and community partners—to join in our university’s efforts to improve the lives in our global community by preparing highly competent, compassionate health leaders. We all have exciting roles to play in this mission.”

I hope campus leadership teams across the country are able to work together in similar ways and can share their experiences of well-integrated, well-functioning partnerships that help guide change and strengthen their institutions.

Angela L. Walker Franklin, PhD, is president and CEO of Des Moines University. She has worked in higher education for more than 35 years and is a licensed clinical psychologist. Previously, she was executive vice president and provost at Meharry Medical College. Earlier, she held several positions at Morehouse School of Medicine, including associate vice president and vice dean.


1. Association of Governing Boards of Universities and Colleges, The Leadership Imperative: The Report of the AGB Task Force on the State of the Presidency in American Higher Education (Washington, DC: 2006), p. 9.

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