I love working with Trustees. They are a very successful, dedicated group of individuals who devote a great deal of time and energy in service to their hospital. According to most bylaws, the Board is ultimately responsible for the quality of the institution. This can be a daunting responsibility for Trustees… most of which are not physicians to begin with, and many are not even in health care. They are very comfortable in their own business environments, but health care is not their primary profession, and to have such a responsibility outside of their field of expertise is understandably challenging.
I would like to offer some suggestions to help the Trustee become not only an advocate of quality, but an Ambassador to the community promoting the quality of the hospital.
1. Embrace the concept of transparency. Transparency has improved performance in all areas in which it has come into contact. Quality and patient experience measures, once becoming public, have improved faster than ever before. Transparency is a process… in fact, it is a way of doing business. Performance universally improves when data is collected, analyzed by the medical staff and administration, and monitored by the Board. The Board must champion this process, promoting the appropriate collection of data, and expect transparency and accountability from administration and the medical staff. Transparency should be your friend, not a begrudging necessity.
2. Implement best practices. If there is a single question a Trustee can ask to most assure the quality of the organization, it would be this: “Are we implementing best practices in every service line that we offer, where best practices are available?” Put simply, evidence-based practices reduce adverse events. The Trustee must challenge the organization to put into place evidence-based practices, and insist on compliance by all health providers.
It is understood that not all areas of medical practice have established best practices, and it is also understood that a best practice cannot possibly apply to all patients– there will be individual patient exceptions based upon the particular medical situation. Also best practices are temporary…. they will change as we learn more. Although they are responsible for the quality of the organization, they do not have to know the best medical treatments; they just have to know that the providers who are treating the hospital’s patients are practicing evidence-based medicine. Therefore, implementing best practices is very reassuring to the Trustee who is not in the medical field.
3. Excel in all clinical indicators– not just Pay for Performance. Health care is quickly moving from a pay for volume to pay for performance. Not only is excellent performance associated with quality; it also results in higher reimbursement for the institution. Bottom line, the institution needs to PROVE its value by excelling in all these measures. Many Boards are now adopting the organizational goal of Zero Defects. Understandably, adverse events will occur, but the goal is Zero. Every adverse event should be investigated to minimize the possibility of it re-occurring. A dashboard of key quality indicators should be adopted by the Board and regularly monitored and managed.
4. Become an Ambassador for Quality. When I facilitate Strategic Planning with hospital Boards, I challenge them to articulate 3-4 “talking points” regarding quality successes within the hospital. We actually write these down and sometimes put them on a reminder card. As the Trustee relates to members of the community, these points are top of mind to “brag” about the hospital. The Trustee is by nature very influential within the community and has many opportunities to relate to individual stakeholders. Having these talking points immediately at hand, gives the Trustee the opportunity to promote the key quality agendas and successes during day to day encounters. Plus, it is very satisfying to go through this process and actually put the successes that the hospital has achieved into concise bullet points.
Yes, it is daunting to be responsible for the quality outcomes of a very complicated health care institution, but if the Trustees can adopt these principles, they are well on their way to becoming the true Quality Ambassador for the hospital.
Stay tuned…. This topic will be expanded in my August Newsletter.