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March 2017 Archive for High Reliability Healthcare

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Systemic solutions to analyze underlying causes of specific care breakdowns and improve overall quality.

How Engaged is Your Board?


Mar 03, 2017 | Comments (0) | 4164 Views

By Ann Scott Blouin, RN, PhD, FACHE
Executive Vice President
Customer Relations
The Joint Commission

Gone are the days when membership on a board of directors meant just casting a few votes at a quarterly meeting. Modern boards of directors are truly partners with the leadership team at hospitals.

Despite general consensus that board members retain responsibility for quality, safety and the financial security of organizations, it can be difficult for board members—especially those newly appointed—to understand how they can best contribute.

To that end, The Joint Commission has released the 3rd edition of Getting the Board on Board: What Your Board Needs to Know About Quality and Patient Safety. This publication is written for both board members and executive audiences, offering the patient safety and quality focus that’s often lacking at new board member orientation.

Challenges to Board Engagement
No executive ever sets out to isolate the board of directors; people volunteer their time on a board to make a difference in a cause that’s important to them. Still, a disconnect somewhere along the line is common.

On the part of the health care organization, senior leadership often hesitates to share their problems with the board. Meeting agenda items rarely outline quality and safety problems, with senior leaders often uncomfortable to share patient stories and challenges.

Lacking this guidance, board members don’t always understand that their fiduciary responsibility includes more than just financial guidance. They may not know that their role is broader and, perhaps  are unaware of what reports on quality and safety are reasonable to expect from senior leaders.

Board Structure
Emphasizing quality and safety is often a simple matter of constructing (or re-constructing) the board agenda and supporting materials. It’s far less complicated than it sounds.

The board should always receive a quality and safety report at the meeting. It’s best if this is presented before the very end of the meeting when time’s running out. 

Some organizations allow patients and their families to share their hospital experience—both good and bad—at board meetings.

It’s a real asset to have a dedicated board committee focusing on quality and safety matters, including:

  • Serious safety events review
  • Risk management trends and patterns
  • Impact upon quality and safety issues due to staffing and other challenges

The Right Questions
Opening a dialogue with senior leaders will go a long way toward closing the communication gap. In the book, an entire section is dedicated to questions board leaders can pose to senior leaders and staff.

Recommended conversation starters include:

  • What is the most important indicator of quality we are tracking?
  • Have there been any serious safety events this month? What type? Where did they occur? What did the root causes show? How do we prevent that from happening again? How does this benchmark with other organizations like us?
  • I’ve heard about high reliability; what are we doing to get to move the needle toward zero harm?

Measuring Goals
Another excellent, ongoing discussion topic is how hospitals are measuring improvements on safety risks; the approaches are guaranteed to be varied.

Most organizations use a dashboard with Hospital Acquired Conditions, Core Measures and Serious Safety Event Rate included. Those that create visual bar graphs, line graphs, and other graphics can help make it easier for the board to understand and ask questions.

There are plenty more nuggets of information in “Getting the Board on Board: What Your Board Needs to Know about Quality and Patient Safety”. Order your copy today and start maximizing your board/leader efficiency.

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