Academic Medical Centers (AMCs) face many challenges, which can lead to financial constraints. For AMCs to remain sustainable in today's healthcare system, the literature presents a compelling case for expansion to mitigate their financial burdens. Expansion often requires quick decision-making, and as a result, scholars repeatedly discuss the importance of AMC governance being both nimble and efficient. The University of Mississippi Medical Center (UMMC) substantially impacts Mississippians, and the institution must remain a thriving center for education, research, and healthcare for the state. Given the importance of efficient and nimble governance in the institution's sustainability, this Dissertation in Practice (DiP) aims to explore the perceptions of the Institutions of Higher Learning Board of Trustees and the University of Mississippi Medical Center senior leadership regarding the efficacy of the current governance structure. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]