Board

1
Boards Rolein Hospital Quality

• New England Rural Hospital Performance
  Improvement Summit
• April 21, 2009

2
Boards Role in Hospital Quality

• Get Engaged
• Wheres the CEO?
• Physician Participation
• Board Leadership
• Champion
• Self assessment

• BOARD QUALITY
• EDUCATION PROGRAM
• A Self-Assessment Tool

http//www.americangovernance.com/americangovernan
ce/education/SAT.pdf
3
Six Governance Levers
Mission
4

Strategic Performance


Mission Performance
Strategic Performance
Corporate Performance
Doing Good
Doing Well
5
Governance vs. Management
OPERATIONS
Domain of Management
BUDGETS
BUSINESS PLANS (TACTICS)
Shared Responsibility
STRATEGY
Performance Targets
Domain of Governance
MISSION
VALUES
6
Boards, Quality Dashboards

• Higher Quality Performance
• Shorter Focused Dashboards, Frequently Reviewed
• Active Use of Dashboards by the Board for QI
  Projects, Operational Oversight and Public
  Reporting
• Board Quality Committees Strongly Influence
  Dashboard Content and Implementation
• Big Dot Focus

7
What Weve Learned

• Board quality literacy is low to moderate
• Mixed definitions of what is considered quality
  expertise on the Board
• Public reporting is strong driver of awareness
• Perceptions between CEO and Board Chair need to
  be aligned
• Agenda time for quality increasing
• Need better integration of measurement, planning
  and incentives

8
Quality Outcomes

• Board Spends More than 25 of their Time on
  Quality Issues
• Receives a Formal Quality Performance Measurement
  Report
• Ties Part of Senior Executive Compensation to
  Quality Performance
• Created a Board Quality Committee
• Received BCBS-MA Grant to Accelerate Quality
  Agenda

9
Board Quality Committee

• Membership
• Physicians and CNO
• Chaired by Lay Board Member
• Responsibilities
• Develop Goals (BHAG)
• Holds Management Accountable
• Meeting management
• The humble agenda - patient stories
• The right topics
• Managing information flow
• Quantity vs quality
• Denominator issue

10
Board Education

• Quality Retreat
• One 6-hour or two, 3-hour sessions
• Include all, but only, the management you need
• Use outside facilitator

• QUALITY CURRICULUM FOR TRUSTEES

http//www.americangovernance.com/americangovernan
ce/education/QC.pdf