New Study Shows Quality Not Top Priority for Nearly Half of Hospital Boards
From a Health Affairs Press Release: Health Affairs  published a study on November 6, 2009 “surveying a nationally representative sample of board chairs in 1,000 U.S. hospitals. The results found that just half the boards rated quality of care as one of their two top priorities and only a minority reported receiving training in quality. This is the first national study of board chairs linked to quality performance.”

“Hospital Governance And The Quality Of Care”
By Ashish K. Jha and Arnold M. Epstein
Abstract
Author affiliations:
Jha and Epstein are affiliated with the Harvard School of Public Health

“In identifying the factors that affect the quality of hospital care, leadership and governance have emerged as areas of particular interest. Since boards of directors could have an impact on quality of care, this study evaluated how hospital leadership values quality. The authors collected their data during the winter of 2007-08 by randomly selecting 1,000 institutions from a group of over 3,000 nonprofit acute care hospitals that reported quality data to the Hospital Quality Alliance (HQA) in 2007. They reached out to their board chairs, and achieved a response rate of 78.3 percent.

“Of those surveyed, a little over half identified quality as one of the two top priorities for board oversight, and only 44% reported that quality of care was important for evaluating the performance of the chief executive officer (CEO). For 63% of the institutions, quality performance was consistently an agenda item at board meetings, compared to financial performance, which was consistently on the agenda at 93% of the hospitals.

“In contrasting hospitals that had scored well in on quality measures with their lower-performing counterparts, the data revealed major differences in attitudes, priorities, and activities around quality of care. “Our data provide clear evidence of an association between an engaged board and high quality care, although we cannot yet pinpoint a causal link,” said Ashish Jha, the study’s lead author. “Most boards have primarily focused on financial issues, mistakenly assuming that their hospital’s quality of care is adequate. Major opportunities exist to shift the knowledge, training, and practices of hospital boards to promote a focus on safe, effective care.”

“This project was funded by the Hauser Center for Non-Profit Governance at Harvard Law School and the Rx Foundation.”

States Get Involved:
New Jersey Hospital Boards–Governance and Quality
In story titled ”This is a test: Exams for governance boards on quality measures could be a way to improve care, accountability in hospitals,” Modern Healthcare’s  Melanie Evans on November 16, 2009, spoke with Sally Roslow, New Jersey Hospital Association (NJHA) vice president of development and trustee relations. According to the story, NJHA ”is expected to give more weight to quality training to promote further education on the issue” in a voluntary training program for trustees on hospital governance that NJHA anticipates launching in 2010. Over 95% of New Jersey hospital boards met a new state requirement that trustees and directors attend seven hours on basic governance by August 2009.

Cheryl Clark reported in HealthLeaders Media on November 9, 2009,”Carlin Lockee, managing editor of the Governance Institute, which assists hospital boards, says she was surprised at the study’s results. She says they differ from the Institute’s similar surveys of nonprofit hospital CEOs.”