Healthcare News & Insights

Hospital boards need to make decisions about quality

Typically, a hospital’s board of directors works behind the scenes, directing management and financial decisions, while leaving patient care to clinicians. But now, it’s important for boards to take a more active role when it comes to quality care.

78163618Although hospital boards often don’t get involved with issues involving quality, they should. According to a recent article in the New York Times, research shows that hospital quality is higher when the board is an active participant in decisions that guide patient care. In some cases, mortality rates even drop for certain conditions.

Money matters

Board members are typically recruited for their financial savvy, either because they’re great at fundraising or because they understand how to crunch the numbers.

However, with Medicare and other private payors shifting toward a fee structure that’s mostly driven by value-based payments, quality and finances are no longer two separate entities. Soon, they’ll become one and the same. And for hospitals to survive and thrive during this shift, executives and board members need to work together to meet quality benchmarks.

So instead of just supporting fundraising efforts, boards should work to create a culture where high performance and efficiency are supported and encouraged.

While research cited in the Times article shows that almost 75% of boards are concerned with a hospital’s financial performance, only about half of boards ranked quality of care as one of their top two concerns.

And only 44% of hospital boards currently use clinical quality as a benchmark for evaluating performance of hospital CEOs. When boards do take a more active role with top hospital executives and improving quality, results are better.

In one study, fewer patients died from heart attacks at facilities where the board had a strong influence when it came to management prioritizing quality.

Decision-making guide

Hospital boards and healthcare execs can work together to promote an environment where quality is of highest importance using several strategies, including the “lean management” style popularized by Toyota.

Here, top executives and board members implement procedures designed to:

  • eliminate inefficiencies and variations
  • promote collaboration among members of the care team, and
  • set clear goals, with a system in place to track progress toward them.

Boards and healthcare executives would also be wise to take advantage of another resource that helps bring about improvement: competition. When working in areas where there’s greater competitive pressure, hospitals are more likely to implement procedures that boost quality.

Just like competition in any other industry, competing boosts quality in health care because it inspires facilities to come up with innovative practices so they can keep up with other hospitals. So boards and executives would be wise to consider the performance of competing hospitals when evaluating their own facility.

Getting started

For board members who may not be familiar with quality issues, either because they don’t have a medical background or haven’t cared for patients in some time, training sessions about quality geared toward their level of understanding may be helpful if you’d like to get the board more active in quality-related decisions.

Per the Times, less than a third of hospital boards receive training like this, but it could make a world of difference when it comes to hospital’s commitment to providing top-notch, high quality care.

It could also be helpful to have some of your hospital’s clinicians pay a visit to your next board meeting so they can give a firsthand account about the quality issues they see on the frontlines. This can give the board additional perspective about the policies they can implement for their facilities.

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