If you or a loved one is having a heart attack, your most pressing concerns probably include how quickly you can get to the hospital and the quality of care you'll receive. You're probably not thinking about the hospital's board room, even though quality of care for heart attacks and many other conditions may be determined in large part by decisions made there. Several studies show that hospital boards can improve quality and can make decisions associated with reduced mortality rates. But not all boards do so. "Most board members are community leaders, serving on the board to support fund-raising goals," said Ashish Jha, a Harvard physician. "They don't think it's their job to hold management accountable for performance."