Study: Hospital boards need more focus on quality of care

Tools

When it comes to promoting quality care, U.S. hospital leaders have room for improvement. Board chairs of U.S. hospitals not only have less training and expertise in quality of care but also devote less of their time to such issues than their English counterparts, according to a new study  in this month's Health Affairs.

The surveys involved responses from 132 of 171 board chairs in England, along with 722 of 922 board chairs in the United States.

The authors found 72 percent of English board chairs considered either patient safety or clinical effectiveness as the top priority for board oversight, compared with only 31 percent of U.S. chairs.

U.S. board chairs also were more likely to cite financial performance or business strategy, as opposed to clinical quality, as the main concern for both board oversight and hospital CEO performance evaluation, the study showed.

Moreover, only 68 percent of U.S. hospitals had care quality performance on every board meeting agenda, compared with 98 percent of English hospitals.

"[T]hese findings from England should spur U.S. policy makers to consider requiring that boards of U.S. hospitals take more responsibility for the quality of care that their institutions provide and spur U.S. hospitals and their boards to seek ways to deepen their involvement in quality and safety concerns," the authors state.

The study authors did acknowledge English hospital board chairs are paid and spend up to three days a week on board responsibilities, while most U.S. hospital board chairs are volunteers and often hold other full-time positions.

The findings echo recommendations from Raymond Hino, interim CEO of Bear Valley Community Hospital in California and FierceHealthcare advisory board member, who said engaging the board in quality-improvement efforts is one of the most important interventions to improve hospital performance.

"This means it is a key to take time on board meeting agendas each month to thoroughly educate our boards on our quality goals," Hino wrote in a November Hospital Impact blog post. "It is up to senior management to educate them."

Hino also emphasized the need to foster alignment among board members, medical staff and executive management to achieve future success, according to a Hospital Impact post last month. For instance, hospitals can establish a joint conference committee composed of two board members, two medical staff workers and the hospital CEO that meets regularly.

For more:
- here's the Health Affairs abstract

Related Articles:
Real health reform requires strong governance
Finding common ground between hospital leadership and staff
Is it time to downsize the governance board?
Improve quality with help from the hospital board
Health systems focus on leadership more than hospitals