Enacting Corporate Governance of Healthcare Safety and Quality: A Dramaturgy of Hospital Boards in England

Abstract

The governance of patient safety is a challenging concern for all health systems.Yet, while the role of executive boards receives increased scrutiny, the area remains theoretically and methodologically underdeveloped. Specifically, we lack a detailed understanding of the performative aspects at play: what board members say and do to discharge their accountabilities for patient safety. This article draws on qualitative data from overt non-participant observation of four NHS hospital Foundation Trust boards in England. Applying a dramaturgical framework to explore scripting, setting, staging and performance, we found important differences between case study sites in the performative dimensions of processing and interpretation of infection control data. We detail the practices associated with these differences -the legitimation of current performance, the querying of data classification, and the naming and shaming of executives -to consider their implications.

Interventions to Reduce Hospital Length of Stay in High-risk Populations

“…This systematic review identified evidence for 8 hospital-based interventions targeting high-risk patient populations: discharge planning, 20,37,38,43,46 geriatric assessment or consultation, 33,39,44,47,49 medication management, 31,34,45 clinical pathways, 36,42 interdisciplinary or multidisciplinary care, 40,48 case management, 35 hospitalist services, 41 and telehealth. 32 As shown Table 3 Hospitalized older patients often have increased costs, complications, worse outcomes, 53,54 and longer LOS compared with younger patients. For example, a study by Freeman et al 53…”

“…32 As shown Table 3 Hospitalized older patients often have increased costs, complications, worse outcomes, 53,54 and longer LOS compared with younger patients. For example, a study by Freeman et al 53…”

Do Hospital Boards matter for better, safer, patient care?

“…Finally, performative and symbolic framings focus on the importance of the symbolic and ceremonial value of Boards, and explore Board performances in a dramaturgical sense (Freeman et al., 2016). Such approaches are based on the assumption that Boards undertake important conditioning work outside of formal Board meetings.…”

Selective Systematic Review: Planned Healthcare Environments Impact on Healing, Health and Well-being

“…The Centers for Disease Control and Prevention, Summary Health Statistics: National Health Interview Survey, 2016 reported that over 36 million people are treated in hospitals across the United States (U.S.) annually [2]. These healthcare organizations are environments where people interact with healthcare experts to achieve healing, health, and wellbeing.…”