Hospital Leadership and Quality Improvement

Levey, Samuel; Vaughn, Thomas; Koepke, Mark; Moore, Duncan T.; Lehrman, William G.; Sinha, Sunil

doi:10.1097/pts.0b013e3180311256

Cited by 31 publications

(33 citation statements)

References 16 publications

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“…High percentages (over 80% in two studies) of Boards had formally established strategic goals for quality with specific targets and aimed to create a quality plan integral to their broader strategic agenda 3237 Contrary findings however suggest that the Board rarely set the agenda for the discussion on quality,37 did not provide the ideas for their strategies32 and were largely uninvolved in strategic planning for QI 48. In the latter case, the non-clinical Board managers felt that they held ‘passive’ roles in quality decisions.…”

Section: Resultsmentioning

confidence: 95%

“…38 45 49–51 Findings imply that this may be too low to have a positive influence on quality and safety, as higher quality performance was demonstrated by Boards that spent above 20%/25% on quality 4950 Board members recognised that the usual time spent is insufficient 48. However, few reported financial goals as more important than quality and safety goals,32 and health system Boards only spent slightly more time on financial issues than quality 51.…”

Section: Resultsmentioning

confidence: 99%

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The role of hospital managers in quality and patient safety: a systematic review

et al. 2014

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ObjectivesTo review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care.DesignA systematic review of the literature.MethodsA search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles.ResultsThe majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals.ConclusionsThere is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

The role of hospital managers in quality and patient safety: a systematic review

et al. 2014

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“…[1][2][3] Effective governance is increasingly valued as an important prerequisite for sustained improvement of delivered care. [1,4] However, recent healthcare incidents suggest that hospital governance is not optimal and hospital boards are in need for methods to assist them in their governance task. [5][6][7][8] There are several sources from which hospital boards can gather quality and safety information, for example safety walk-arounds, patient safety indicators, incident reports, infection rates, patient satisfaction surveys, risk registers and adverse events meetings.…”

Section: Introductionmentioning

confidence: 99%

Optimal governance of patient safety: A qualitative study on barriers to and facilitators for effective internal audit

Gelderen

Hesselink

Westert

et al. 2017

JHA

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Objective: While internal audits are widely used, insight into the essential components of the internal audit to govern patient safety is limited. The aim of this study is to explore factors that hinder and stimulate internal audits as an effective patient safety governance tool for hospital boards. Methods: A qualitative interview study in six Dutch hospitals. Interviews (n = 43) were held with auditees, quality officers, boards of directors and boards of supervisors. Data were collected and analysed using Grounded Theory. Results: Barriers and facilitators were classified into 14 categories from which four themes emerged: (1) board positioning of audits, (2) organisation and content of audits, (3) competences and composition of audit team, and (4) cultural factors and attitudes towards auditing. Conclusions: We found two themes consisting of factors related to the audit itself (organisation and content of audits, and competences and composition of audit team) and two themes consisting of contextual factors (board positioning of audits, and cultural factors and attitudes towards auditing). These may contribute to support for auditing and to the generation of reliable audit results, which subsequently could result in effective audits for governance of patient safety. Hospital boards and executives can optimise the patient safety auditing system in their hospitals by increasing active leadership engagement, by promoting audits as an opportunity for staff to learn from safety problems (rather than a mandatory examination instrument) and by providing vital resources for a smooth audit process, such as a medical specialist in the audit team.

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“…The roles of the CEO, the medical staff, and prominent community members on hospital governing boards have been well documented. 4,5 Unfortunately, nurses, who represent the greatest proportion of healthcare providers at the point of care and stand to make the biggest Creation of an academic liaison position to provide support for return to school Provide funding to support specialty certification and continuing education * CNO indicates chief nursing officer.…”

Section: Nurses Not Positioned At Top Executive Levelsmentioning

confidence: 99%

The CNO

Tagnesi

Dumont²,

Rawlinson³

et al. 2009

Nursing Administration Quarterly

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Moving a southern rural community medical center through the multitude of regulatory, fiscal, social, cultural, and political changes required for healthcare excellence in the early 21st century has provided some particularly unique challenges. This article describes opportunities and initiatives taken by a chief nursing officer and key members of the healthcare team to meet the challenges of moving a rural and rapidly growing healthcare system toward excellence. The initiatives and perspectives of the team, the chief nursing officer, performance improvement/quality corporate director, the board chairman, and nursing leaders, are presented.

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Hospital Leadership and Quality Improvement

Cited by 31 publications

References 16 publications

The role of hospital managers in quality and patient safety: a systematic review

The role of hospital managers in quality and patient safety: a systematic review

Optimal governance of patient safety: A qualitative study on barriers to and facilitators for effective internal audit

The CNO

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