The Hospital Board Room

If you have been to one Board Room meeting, you have been to many.  

It is in this room, where the healthcare quality professional (i.e. Chief Nursing Officer, Chief Medical Officer/Vice President of Medical Affairs, Vice President of Performance Improvement, Director of Quality) must have a substantive presence and voice. 

Most importantly, this is the theatre where the Quality and Patient Safety agenda must rise and become the primary character, while the financial content plays the supporting cast.  Rather than a mere 5%-10% of the time, the Hospital Board should spend a minimum of 25% of all deliberations on Hospital Quality and Patient Safety related matters.

To this end, the healthcare quality professional should be capable of assisting the Board with three (3) essential vehicles:

• Establishing a Board Quality Committee (BQC) - and its agenda items.  
• Identifying appropriate patient stories that can be brought to the Board and shared, each month.
• Developing a strategically aligned organizational dashboard (no more than six indicators) with meaningful targets and definitions.

The cornerstone to Hospital Board oversight is not the financial statement, but rather patient care and the environment in which this care is delivered.

To learn further details, please go to www.ihi.org/IHI/Programs/Campaign/BoardsonBoard.htm

-soft of people, hard on processes

Hospital Quality Overwhelming, But Necessary

Whether one works in a large urban teaching hospital or a small rural community, the professional life and responsibility of the Healthcare Quality Professional is arduous, and often times overwhelming.  The national hospital quality agenda contains essential elements such as: continuous preparedness for Joint Commission accreditation and/or state conditions of participation, data reporting transparency, ongoing physician practice evaluation, patient satisfaction benchmarking, bedside medication verification, computerized physician order entry, electronic medical record implementation, infection control, case management, responding to patient grievances, and effective information management, to name a few.  How does one effectively manage these program elements so that the RIGHT patient, receives the RIGHT care, at the RIGHT time?

Ask any of my peers throughout the country, and they will tell you there are several organizational ingredients that contribute to successful program development and implementation.  Furthermore, I would argue that program sustainability is severely compromised without all five (5) of these ingredients firmly place.  You will find that the Institute for Healthcare Improvement (IHI) provides first-rate research and recommendations in how to incorporate many of these ingredients into your organization.

• Substantive engagement by the Board of Directors, which is reflected by the agenda outline and time spent on Quality and Patient Safety
• Senior Management stewardship and accountability for Quality and Patient Safety operations and strategy, which is demonstrated by the utilization of transparent scorecards or a system dashboard
• Proper buy-in and support of the CFO with the Quality and Patient Safety hospital strategy
• Partnering with the medical and nursing staffs to deliver the clinical elements of the program.  The President of the Medical Staff, the Vice President of Medical Affairs, and the Chief Nursing Officer and Director of Quality, should work closely on matters pertaining to clinical performance improvement.
  
• Proper funding and staffing of Information Technology services

I shall provide further depth to each of these ingredients in future blog posts.

-soft on people, hard on processes