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Today’s hospital boards play a more significant role in quality and patient safety improvement efforts than ever before. Some board members’ first instinct might be to try to manage everything—including clinical care, experts say. A hospital’s senior leadership must help board members understand the quality process and ask informed questions about the delivery of care.

Yosef D. Dlugacz, PhD
Senior Vice President and Chief of Clinical Quality, Education and Research
Krasnoff Quality Management Institute
Great Neck, NY


The first step is to define the hospital board’s role, responsibility, expectations and accountability for the quality-management process. I devote a formal class of several hours that introduces board members to quality management principles, methods, tools and communication techniques. I use incidents as a way to educate board members about root-cause analysis findings and improvement strategies. My advice to other executives is to take quality out of the realm of theory into practice whenever possible. Sitting through hours of committee meetings with clinicians expounding about the rates of immunization for two-year-olds is much less captivating than making a field trip to an ambulatory site and exposing them to the problems—language, culture and trust—encountered in delivering healthcare services. The goal is

Todd C. Linden
President and CEO
Grinnell Regional Medical Center
Grinnell, IA


Develop a board quality committee that is populated with interested and motivated members, including clinician members of the board. The first goal of this committee should be defining what quality means for the institution and identifying metrics that provide meaningful information for the board to track quality. Another focus should be continuing board education on quality and patient safety. Last year, we set aside a complete board meeting on quality and made it the principal focus of the last two board retreats, which included outside speakers on quality. Look to the board development committee to assess the board’s knowledge and provide focused educational activities. Consider recruiting a quality improvement expert for the board. In our case, the catalyst for board inspiration has been largely driven by a retired nurse committed to patient-focused care and quality.

—Carrie Vaughan