Lifecycle management of assets is essential for cost-effective maintenance and long-term economic viability. Properly maintained infrastructure provides significant economic advantages. Neglecting maintenance leads to lower productivity and imposes costs on users. Furthermore, delayed maintenance significantly increases total costs associated with repair or replacement. Lifecycle asset management should be used in the public sector to manage large-scale assets such as transportation infrastructure in a cost-effective manner. Yet, state governments have had little incentive to provide proactive maintenance. To address the infrastructure capital investment backlog, particularly acute in transportation, government priorities need to be coupled with long-term economic accountability. In addition, funding and financial reporting mechanisms should be created to ensure effective and efficient lifecycle asset management decisions. Public-private partnerships (PPP) also need to be fostered to help address regional deficiencies in infrastructure.

Intervention, such as that performed via surgical procedures, is necessary when a board of directors is not functioning as it should. Unlike medical procedures, members of a board of directors have to perform surgery on themselves for change to occur. Board surgery might require resizing the board, invoking term limits, establishing conflict of interest policies, and increased emphasis on board member competencies. This article describes the symptoms leading to the need for surgery and suggests that it is better to perform elective surgery rather than letting problems reach the point of requiring emergency surgery.