Organizational Factors Associated with High Performance in Quality and Safety in Academic Medical Centers

Keroack, Mark A.; Youngberg, Barbara J.; Cerese, Julie; Krsek, Cathleen; Prellwitz, L.; Trevelyan, Eoin W.

doi:10.1097/acm.0b013e318159e1ff

Cited by 118 publications

(73 citation statements)

References 13 publications

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“…48 Qualitative studies of AMI care also provide support for many of the practices defined inTable 1. 12,49,50 In our study, a movement from the 25th to the 75th percentile in management scores was associated with a 0.17% reduction in mortality, a potentially important although modest improvement. A number of studies have indicated that process-of-care measures are correlated with lower AMI mortality, although the magnitude of effect has also been small.…”

Section: Commentmentioning

confidence: 81%

Management Practices and the Quality of Care in Cardiac Units

McConnell¹,

Lindrooth²,

Wholey³

et al. 2013

JAMA Intern Med

100

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Section: Commentmentioning

confidence: 81%

Management Practices and the Quality of Care in Cardiac Units

McConnell¹,

Lindrooth²,

Wholey³

et al. 2013

JAMA Intern Med

100

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“…Quality must be a focus of the entire organization-not simply the responsibility of the clinical or risk-management leadership or specific change-methodology agents. 29 Integration with governance and operations is critical. A clear and discrete focus is required.…”

Section: Discussionmentioning

confidence: 99%

The Quality ‘Journey’ At Ascension Health: How We’ve Prevented At Least 1,500 Avoidable Deaths A Year—And Aim To Do Even Better

et al. 2011

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A decade ago the Institute of Medicine estimated that 44,000-98,000 preventable deaths occur each year in US hospitals. The leaders of Ascension Health-one of the nation's largest health care delivery networks, with sixty-nine hospitals in twenty states and the District of Columbia-dedicated themselves to preventing equivalent numbers of deaths in their system. In 2003 they set a goal of reducing preventable deaths by 900 each year by 2008. By fiscal year 2010 Ascension Health had reduced preventable deaths by more than 1,500 people annually and, by some calculations, by more than 5,000 people annually, compared to 2004. Ascension Health had also achieved important improvements in preventing birth trauma and reducing rates of pressure ulcers and hospital-acquired infections. The health care system could achieve even greater results by adopting the safety principles used in high-reliability entities such as the nuclear power industry. The adoption of such principles can lead to impressive improvements in health care quality.

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“…17,18 Much of it has focused on whether better management improves the efficiency and financial performance of hospitals 19,20 or on clinical engagement by hospital management. [21][22][23][24][25] We extend this literature by applying a data-driven taxonomy of managerial practices at the hospital level to provide empirical insight into the relationship among hospital governance, management, and clinical performance.…”

Section: Exhibitmentioning

confidence: 99%

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Jha²,

et al. 2015

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National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of highperforming hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery.H ospitals increasingly face financial pressure to improve quality through national programs such as Hospital Value-Based Purchasing, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program. Despite the recently increased emphasis by policy makers on linking payment and quality, quality improvement efforts have traditionally focused on the processes and outcomes of clinical providers. Less is known about how two critical elements, leadership and management, influence the delivery of high-quality care and how those effects might be empirically verified. 1 Several previous studies have shown an association between hospital board practices and quality of care. 2-5 Although these studies have been helpful, they have not been able to clearly delineate which specific activities of the boards affect quality of care and how they relate to hospital managers' activities. Furthermore, it is unclear whether board activities and management activities are independently important in driving quality performance. It is known that there are large variations in both how hospital boards engage with clinical quality as well as managerial practices across institutions. 2,5-8 Understanding how hospital boards and management interact with each other, and the way in which they might drive gains in quality, is critically important. The lack of empirical data in this area, however, has

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Organizational Factors Associated with High Performance in Quality and Safety in Academic Medical Centers

Abstract: Distinctive leadership behaviors and organizational practices are associated with measurable differences in patient-level measures of quality and safety.

Cited by 118 publications

References 13 publications

Management Practices and the Quality of Care in Cardiac Units

Management Practices and the Quality of Care in Cardiac Units

The Quality ‘Journey’ At Ascension Health: How We’ve Prevented At Least 1,500 Avoidable Deaths A Year—And Aim To Do Even Better

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

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