Quality of care & Hospital Boards

Quality of care is among the ‘triple threats’ (other being cost and service) labeled by Berwick facing by the healthcare system. Who is ultimately responsible for quality? You may not guess the real answer. It is: Hospital Boards! Board of Directors or Trustees have the ultimate responsibility. 85% of Boards are not-for-profit. A study by Ashish Jha in Health Affairs this month looks at the Board engagement by Boards in the quality of care at U.S hospitals. Their responses were from722 chairs who had served an average of over 12 years on the Board. Sadly, only 8% of Board members were physicians. Only 44% of Board members identified quality performance as one of the two most important criteria for evaluating the CEO. AS you know evaluation of the CEO is THE most important of the Board’s responsibility. The study detected large differences in governance between the highest and lowest performing hospitals. 
Comment: Why am I not surprised? I have repeatedly said that if you want change and put emphasis on the quality of care and focus back on the patient, physicians need to be a larger part of any Board. Although all Boards have a QA sub-committee and its on the agenda, having been on hospital Boards, it does not get the priority it deserves.