GOVERNANCE BEST PRACTICES Talking With Boards About Quality of Care and Patient Safety

1. GOVERNANCE BEST PRACTICESTalking With Boards About Quality of Care and Patient Safety John Brozovich, MBA Principal JOHN BROZOVICH ASSOCIATES, INC. May 4, 2006

2. SCOPE • Define Governance Oversight Best Practices • Conduct Field Practice Interviews • Complete Literature Review • Produce Findings: Eight Best Practices • Verify with small group of CEOs • Validate with large group of CEOs: May 4 • Recommend Action to Board members: June 28

3. What is a Quality & Patient Safety Governance Best Practice ? A QPS Governance Best Practice is: • Intentional work of the Board or a committee • That occurs with a predetermined frequency • Which brings focus and accountability to an important QPS matter • To insure quality and/or patient safety

4. GOVERNANCE QPS BEST PRACTICES 1. The Hospital Governing Board reviews a performance “dashboard” or balanced scorecard of critical quality indicators to identify areas for improvement 2.The Hospital Governing Board requires major new hospital clinical programs or services to meet quality-related performance criteria

5. GOVERNANCE QPS BEST PRACTICES 3.The Hospital Governing Board includes quality-related goals when evaluating senior executives annually 4.The Hospital Governing Board requires management to have an up-to-date medical staff development plan every two years

6. GOVERNANCE QPS BEST PRACTICES 5. The Hospital Governing Board reviews a report of the organization’s employee satisfaction scores against comparative data at least every two years 6.The Hospital Governing Board reviews a report of the organization’s patient satisfaction against comparative data at least quarterly

7. GOVERNANCE QPS BEST PRACTICES 7. The Hospital Governing Board reviews a report of the organization’s physician satisfaction against comparative data at least every two years 8. The Hospital Governing Board reviews a report on the organization’s patient safety in comparison to national goals at least annually

8. Interview Table CEO INTERVIEWS 8 7 6 5 4 3 2 1

9. 1st Question for Discussion Do we do we have a consensus to support the Governance Institute’s model of QPS Best Practices? In light of the findings, should we include physician satisfaction as a core measure?

10. 2nd Question for Discussion Do we add a QPS Best Practice that states: The Governing Board conducts an annual self assessment for quality and patient safety?

11. ANOTHER IMPORTANT FINDING Many of those interviewed identified a gap in available and affordable continuing governance education to support new board member orientation and existing board member skill development

12. 3rd Question for Discussion Should AWPHD raise core dues by $500 per hospital to support development of governance education for: • New committee chair • New Board chair • CEO and chair • CEO goal setting • Conflict of interest AWPHD or WSHA?

13. Questions ?

14. THANK YOU! Contact Information: John Brozovich, Principal John Brozovich Associates, Inc. 9014 SE 53rd Place, Suite 110 Mercer Island, WA 98040 Email: johnbrozovich@yahoo.com Telephone: (206) 310-6371