Board Oversight of Quality: Any Differences in Process of Care and Mortality?

Hj, Jiang; Lockee, Carlin; Bass, Karma; Fraser, Irene

doi:10.1097/00115514-200901000-00005

Cited by 98 publications

(129 citation statements)

References 8 publications

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“…[1][2][3][4][5][14][15][16] Our findings contribute to this literature by providing novel evidence on how board and management practices interact with each other and their relationship with quality. We found that several structural features of hospitals, such as teaching hospital status, were related to better management scores.…”

Section: Discussionmentioning

confidence: 86%

“…1 Several previous studies have shown an association between hospital board practices and quality of care. [2][3][4][5] Although these studies have been helpful, they have not been able to clearly delineate which specific activities of the boards affect quality of care and how they relate to hospital managers' activities. Furthermore, it is unclear whether board activities and management activities are independently important in driving quality performance.…”

mentioning

confidence: 99%

“…It is known that there are large variations in both how hospital boards engage with clinical quality as well as managerial practices across institutions. 2,[5][6][7][8] Understanding how hospital boards and management interact with each other, and the way in which they might drive gains in quality, is critically important. The lack of empirical data in this area, however, has hampered the ability to intervene on these factors and improve care.…”

mentioning

confidence: 99%

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Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Jha²,

et al. 2015

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National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of highperforming hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery.H ospitals increasingly face financial pressure to improve quality through national programs such as Hospital Value-Based Purchasing, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program. Despite the recently increased emphasis by policy makers on linking payment and quality, quality improvement efforts have traditionally focused on the processes and outcomes of clinical providers. Less is known about how two critical elements, leadership and management, influence the delivery of high-quality care and how those effects might be empirically verified. 1 Several previous studies have shown an association between hospital board practices and quality of care. 2-5 Although these studies have been helpful, they have not been able to clearly delineate which specific activities of the boards affect quality of care and how they relate to hospital managers' activities. Furthermore, it is unclear whether board activities and management activities are independently important in driving quality performance. It is known that there are large variations in both how hospital boards engage with clinical quality as well as managerial practices across institutions. 2,5-8 Understanding how hospital boards and management interact with each other, and the way in which they might drive gains in quality, is critically important. The lack of empirical data in this area, however, has

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Section: Discussionmentioning

confidence: 86%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Jha²,

et al. 2015

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“…The literature suggests an association between Board engagement in quality and risk adjusted hospital mortality rates [7,8,[10][11][12]. The literature, moreover, indicates that assertive questioning by Board members is associated with clinical content of Board minutes and a tendency for better performance [1].…”

Section: Discussionmentioning

confidence: 99%

Non-Executive Directors and Mortality Assurance in the NHS ? Are they Fit for Purpose?

Burrow¹,

O’Donoghue²,

Spurgeon

et al. 2013

Occup Med Health Aff

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“…Quality performance was measured in both process of care and outcomes (20). An example of process of care measure for heart attack was if patients had received aspirin, provided there was no aspirin contraindication, within 24 hours before or after hospital arrival.…”

Section: Leadership Priorities and Patient Safetymentioning

confidence: 99%

Roadmap for patient safety research: approaches and roadforks

Hofoss

Deilkås

2008

Scand J Public Health

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Patient safety improvement is a healthcare priority worldwide. Pioneer research reports include the 1984 Harvard Medical Practice Study, and the 1999 report "To err is human''. Patient safety research is expanding rapidly. Among the Scandinavian countries, Denmark is the patient safety improvement leader, and Norway is the laggard, having only recently institutionalized safety research and then having started with industrial safety research, and only recently having expanded into patient safety research. Aims: To produce a roadmap for patient safety research, indicationg three main roadforks. Patient safety research can be conducted along a number of lines. To identify patient safety problems and come up with ideas for patient safety improvement one can investigate 1) particular cases of adverse events, 2) the design of healthcare delivery systems, or 3) the culture of the care-giving institutions. The study of safety culture can be subdivided into the study of organization culture in general (and in particular of leadership culture) and the study of patient safety culture. The article provides a number of references to existing instruments of patient safety research. Methods: Qualitative interpretation of the referenced literature. Results: Scrutinizing adverse events for errors is health care's traditional way of improving patient safety. The idea of rethinking the design of care delivery systems has been accompanied by claims of modernity. The study of patient safety culture is the most recent approach. The three approaches are discussed in separate sub-chapters. Conclusions: Although chronology suggests a developmental trend, the three approaches should not necessarily be seen as steps up the ladder of evolution. Each approach does have its merits.

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Board Oversight of Quality: Any Differences in Process of Care and Mortality?

Cited by 98 publications

References 8 publications

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Non-Executive Directors and Mortality Assurance in the NHS ? Are they Fit for Purpose?

Roadmap for patient safety research: approaches and roadforks

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