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Bored Room to Board Room: Putting Quality on the Agenda

Bored Room to Board Room: Putting Quality on the Agenda. Why Do We Care?. Role of the Board of Directors. Core fiduciary responsibility Duty of Care Components of quality Clinical Operational Regulatory Credentialing and privilege granting. Why Is This a Critical Need?.

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Bored Room to Board Room: Putting Quality on the Agenda

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  1. Bored Room to Board Room:Putting Quality on the Agenda

  2. Why Do We Care?

  3. Role of the Board of Directors • Core fiduciary responsibility • Duty of Care • Components of quality • Clinical • Operational • Regulatory • Credentialing and privilege granting

  4. Why Is This a Critical Need? • 37 key indicators for 5 health care system dimensions of care scored the U.S. @66 out of a possible 100 • Efficiency was the single worst score • U.S. world wide leader in costs • U.S. scored 15th out of 19 in mortality attributable to health care services • Basic health IT tools lacking to track patients throughout their lives • Improving performance could save 100-150,000 lives annually and approx. $50-100 billion annually *Source: U.S. Dept of HHS, Office of the Inspector General

  5. Interrelation of Quality • Reimbursement and payment • Efficiency • Cost controls • Collaboration between organization, its providers and independent practitioners

  6. How Do We Define Quality • Safety, or freedom from accidental harm • Effectiveness or evidence based care • Patient centeredness • Timeliness of care for appointments, diagnosis and treatment • Efficiency or care delivered with optimal use of resources • Equitable care

  7. Steps to a Successful Quality Program • CEO’s performance evaluation includes objective measure for achievement of clinical improvement goals & patient safety goals • Board participates in the approval of criteria for MD appointments, re-appointments & clinical privileges • Board agenda focuses on quality performance at least 25% of the agenda time (not on consent agenda) • New board members receive orientation about quality programs and then attend regular quality educational sessions

  8. Steps to a Successful Quality Program • Medical staff in involved in setting the agenda for the board’s discussion surrounding quality • Benchmark but know your targets • Adopt best practices for safety • Transparency in reporting; particularly with risk management • Sentinel events reported to full board with corrective action plan developed • Use oral tradition: storytelling can be a powerful tool

  9. Steps To a Successful Quality Program • Make the quality committee a prestigious committee assignment • Include quality in your mission statement • Evaluate results through a “quality lens” • Good internal processes = good quality • Good feedback loop is key • Select board members with certain expertise • Clinical • Financial • Regulatory • Legal • Community based

  10. Ask The Right (Hard) Questions • What are the goals of the organizations quality improvement program? Where are we now and what is the best of the best? • How is each goal linked to management accountability? • Who are the key managers and clinical leaders responsible for quality and safety? • What metrics and benchmarks are used to monitor progress?

  11. Ask The Right (Hard) Questions • How is the organization’s quality assessment and improvement processes integrated into overall corporate policies? • How does the quality program and corporate compliance intersect? • If a sentinel event occurs what is the process for ensuring corrective actions are effective? • What protections are in place for staff to ensure ease of reporting? • How does each department articulate their role in quality and its impact on patient care outcomes?

  12. Board commitment to a culture of quality ensures that everyone in the institution will make quality their priority

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