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Next level of board accountability in health care quality

Peter J. Pronovost (Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland, USA) (Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA)
C. Michael Armstrong (Johns Hopkins Medicine, Baltimore, Maryland, USA)
Renee Demski (The Johns Hopkins Hospital and Johns Hopkins Health System, Baltimore, Maryland, USA) (Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland, USA)
Ronald R. Peterson (Johns Hopkins Health System, Baltimore, Maryland, USA) (Johns Hopkins Medicine, Baltimore, Maryland, USA)
Paul B. Rothman (Johns Hopkins Medicine, Baltimore, Maryland, USA)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 2 January 2018

Issue publication date: 6 March 2018

1035

Abstract

Purpose

The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety.

Design/methodology/approach

Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes.

Findings

The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model.

Originality/value

This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors’ knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.

Keywords

Acknowledgements

The authors wish to thank Christine G. Holzmueller, BLA for reviewing and editing the manuscript. The authors have no conflicts to disclose relative to the content of this manuscript.

Citation

Pronovost, P.J., Armstrong, C.M., Demski, R., Peterson, R.R. and Rothman, P.B. (2018), "Next level of board accountability in health care quality", Journal of Health Organization and Management, Vol. 32 No. 1, pp. 2-8. https://doi.org/10.1108/JHOM-09-2017-0238

Publisher

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Emerald Publishing Limited

Copyright © 2018, Emerald Publishing Limited

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