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Refocus Your Board’s Attention on Quality and Patient Safety


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By Kathryn K. Leonhardt, MD, MPH, CPHQ, CPPS, Principal Consultant, Joint Commission International

Healthcare boards are typically composed of a diverse array of leaders from different backgrounds, each with unique areas of expertise. While this collective knowledge is invaluable in the execution of strategic and long-term planning, it is important to remember that a governing board is ultimately responsible for maintaining high-quality, safe patient care.

Because of this, Joint Commission Resources (JCR) created the Board Education Resource Center: a collection of complimentary resources to give boards and executive teams the vital support and education they need to best serve their organizations and communities.

Board Involvement Is Essential to Program Success
According to the American Hospital Association’s 2022 National Health Care Governance Survey Report, 50% of boards rate quality of care among their top two priorities, yet 37% fail to include quality performance reviews on every agenda. In addition, 58% of boards dedicate less than 20% of their time to quality, despite accountability for patient safety and quality falling heavily in their care.

The Joint Commission requires that governing bodies take oversight of areas such as organizational leadership, medical staffing, patient rights and performance improvements, elaborated in nearly 20 elements of performance (EPs) related to board responsibilities. Specific to patient safety, overarching board governance responsibilities include:

  • Cultivating a culture firmly rooted in quality and patient safety.
  • Establishing a foundational understanding of quality and patient safety principles.
  • Holding medical staff accountable for quality and patient safety.
  • Providing resources to maintain safe, quality care, treatment and services.
  • Making performance improvement initiatives a priority.
  • Ensuring sustained board involvement in these activities sets a precedent for the rest of the organization to prioritize quality and patient safety.

Assessing the Efficacy of a Governing Board
Despite the critical nature of board involvement, many boards are not consistently, effectively or regularly educated on quality or their role as it relates to quality and patient safety. To be effective, board members must remain well-equipped with the knowledge and tools to manage current risks and anticipate upcoming trends.

Seventy percent of respondents reported altering their governing board structure in an attempt to improve the efficacy of their governance. However, 61% of those same boards said they have no statutes in place that require their members to engage in continuing education. This demonstrates that the overwhelming majority of boards want to do better–and have made a concerted effort to do so–but nearly as many do not hold their members accountable to pursue further education.

Actionable Ways to Improve Board Governance
Adhering to the constantly evolving reforms and regulations within the healthcare sector poses a challenge. Presented with complexities at every corner, boards can lose focus. In response, JCR has developed a sample agenda for boards to help ensure patient safety and quality of care remain in focus. With explicit agenda points, boards can:

  • Push engagement beyond overseeing reports provided by a quality committee.
  • Proactively develop goals accompanied by easily implemented framework.
  • Execute self-assessments to identify both achievements and weaknesses.

Visit the Board Education Resource Center
JCR believes that a board dedicated to upholding quality and patient safety can help improve the care provided by an organization. The Board Education Resource Center offers boards and their executive teams access to free resources to help healthcare organizations develop a clear pathway to success, including those on:

  • What the board needs to know about quality and patient safety.
  • Why the board must be involved.
  • How the board can be more effective.
  • Who the board can learn from.

To learn more, visit the Resource Center.

Kathryn K. Leonhardt, MD, MPH, CPHQ, CPPS, is a principal consultant for Joint Commission International (JCI). She is a preventive medicine/public health physician with over 30 years of experience in public, private and academic healthcare organizations.

Dr. Leonhardt has held leadership roles in quality, patient safety and patient experience. Her research and publications have included epidemiologic investigations, Phase III clinical trials and quality improvement projects, including an Agency for Healthcare Research and Quality-funded (AHRQ) project on patient advisory councils. Through the JCI Quality Management & Patient Safety Program, Dr. Leonhardt has led the education and training of 3,500 healthcare professionals from over 40 countries.