May 30, 2017
By Steven Berman
The Joint Commission Journal on Quality and Patient Safety
Board members play a vital role in ensuring high-quality care and patient safety in health care organizations. However, a new study suggests problematic gaps between what board members think they know and what they do in regards to quality and safety, as well as board members’ capability in quality and safety, as assessed by safety and quality leaders (SQLs) at their own health care organizations.
In “Closing the Gap and Raising the Bar: Assessing Board Competency in Quality and Safety,” from the June 2017 issue of The Joint Commission Journal on Quality and Patient Safety: Patricia A. McGaffigan, RN, MS, CPPS, chief operating officer and senior vice president, Programs, National Patient Safety Foundation, [which has since merged into the Institute for Healthcare Improvement], and co-authors, conducted a 36-question survey with a convenience sample of board members, CEOs and SQLs.
Assessing Board Competency
A large percentage of each group among the 605 respondents—105 board members, 53 CEOs, and 447 SQLs—reported that safety was ranked as number one on their organization’s list of strategic priorities. Analysis of responses concerning their knowledge and understanding of specific concepts, such as leadership, culture, serious events and harm prevention, revealed similar patterns across the three groups. In addition, findings revealed:
CEOs rated their own knowledge and understanding as highest.
Board members reported lower ratings of their own knowledge and understanding.
SQLs were less likely to rate their own board members’ knowledge and understanding as “high.”
The authors conclude that the survey “reveals specific areas of focus for improving governance and leadership practices at board meetings, as well as several areas where knowledge and understanding of safety and quality were variable. Further research and consensus would be beneficial to identify best practices for board education and governance activities to drive quality and safety.”
In an accompanying editorial, “Knowing, and Doing: Closing the Gaps in Board Leadership for Improvement of Quality and Safety,” James L. Reinertsen, MD, president, The Reinertsen Group, Alta, Wyoming, and senior fellow, Institute for Healthcare Improvement, Cambridge, Massachusetts, states that “The study reaffirms it would be a good idea to develop more capable boards, both by recruiting board members with expertise in quality and safety, and by offering all board members the opportunity to ground themselves in serious knowledge of quality and safety concepts and methods. But it is even more important that we establish practices—at the board level, and at the quality/safety committee level—that allow our board members to apply their knowledge effectively.”