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Board oversight of quality: any differences in process of care and mortality?
J Healthc Manag. 2009 Jan-Feb; 54(1):15-29; discussion 29-30.JH

Abstract

In response to legal and accreditation mandates as well as pressures from purchasers and consumers for quality improvement, hospital governing boards seek to improve their oversight of quality of care by adopting various practices. Based on a previous survey of hospital presidents/chief executive officers, this study examines differences in hospital quality performance associated with the adoption of particular practices in board oversight of quality. Quality was measured by performance in process of care and risk-adjusted mortality, using the Hospital Compare data from the Centers for Medicare & Medicaid Services and the Healthcare Cost and Utilization Project inpatient databases of the Agency for Healthcare Research and Quality. Board practices found to be associated with better performance in both process of care and mortality include (1) having a board quality committee; (2) establishing strategic goals for quality improvement; (3) being involved in setting the quality agenda for the hospital; (4) including a specific item on quality in board meetings; (5) using a dashboard with national benchmarks that includes indicators for clinical quality, patient safety, and patient satisfaction; and (6) linking senior executives' performance evaluation to quality and patient safety indicators. Involvement of physician leadership in the board quality committee further enhanced the hospital's quality performance. Taken together, these findings seem to support the will-execution-constancy of purpose framework on improving the effectiveness of hospital boards in overseeing quality. Future study should examine how specific board practices influence the culture and operations of the hospital that lead to better quality of care.

Authors+Show Affiliations

Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland, USA. joanna.jiang@ahrq.hhs.govNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19227851

Citation

Jiang, H Joanna, et al. "Board Oversight of Quality: Any Differences in Process of Care and Mortality?" Journal of Healthcare Management / American College of Healthcare Executives, vol. 54, no. 1, 2009, pp. 15-29; discussion 29-30.
Jiang HJ, Lockee C, Bass K, et al. Board oversight of quality: any differences in process of care and mortality? J Healthc Manag. 2009;54(1):15-29; discussion 29-30.
Jiang, H. J., Lockee, C., Bass, K., & Fraser, I. (2009). Board oversight of quality: any differences in process of care and mortality? Journal of Healthcare Management / American College of Healthcare Executives, 54(1), 15-29; discussion 29-30.
Jiang HJ, et al. Board Oversight of Quality: Any Differences in Process of Care and Mortality. J Healthc Manag. 2009 Jan-Feb;54(1):15-29; discussion 29-30. PubMed PMID: 19227851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Board oversight of quality: any differences in process of care and mortality? AU - Jiang,H Joanna, AU - Lockee,Carlin, AU - Bass,Karma, AU - Fraser,Irene, PY - 2009/2/21/entrez PY - 2009/2/21/pubmed PY - 2009/3/27/medline SP - 15-29; discussion 29-30 JF - Journal of healthcare management / American College of Healthcare Executives JO - J Healthc Manag VL - 54 IS - 1 N2 - In response to legal and accreditation mandates as well as pressures from purchasers and consumers for quality improvement, hospital governing boards seek to improve their oversight of quality of care by adopting various practices. Based on a previous survey of hospital presidents/chief executive officers, this study examines differences in hospital quality performance associated with the adoption of particular practices in board oversight of quality. Quality was measured by performance in process of care and risk-adjusted mortality, using the Hospital Compare data from the Centers for Medicare & Medicaid Services and the Healthcare Cost and Utilization Project inpatient databases of the Agency for Healthcare Research and Quality. Board practices found to be associated with better performance in both process of care and mortality include (1) having a board quality committee; (2) establishing strategic goals for quality improvement; (3) being involved in setting the quality agenda for the hospital; (4) including a specific item on quality in board meetings; (5) using a dashboard with national benchmarks that includes indicators for clinical quality, patient safety, and patient satisfaction; and (6) linking senior executives' performance evaluation to quality and patient safety indicators. Involvement of physician leadership in the board quality committee further enhanced the hospital's quality performance. Taken together, these findings seem to support the will-execution-constancy of purpose framework on improving the effectiveness of hospital boards in overseeing quality. Future study should examine how specific board practices influence the culture and operations of the hospital that lead to better quality of care. SN - 1096-9012 UR - https://www.unboundmedicine.com/medline/citation/19227851/Board_oversight_of_quality:_any_differences_in_process_of_care_and_mortality L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=19227851.ui DB - PRIME DP - Unbound Medicine ER -