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  • August 2015
  • Article
  • Health Affairs

Hospital Board and Management Practices Are Strongly Related to Hospital Performance on Clinical Quality Metrics

By: Thomas C Tsai, Ashish K. Jha, Atul A. Gawande, Robert S. Huckman, Nicholas Bloom and Raffaella Sadun
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Abstract

National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of high-performing hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery.

Keywords

Hospitals; Quality; Governing and Advisory Boards; Management Practices and Processes; Service Delivery; Health Care and Treatment; Health Industry

Citation

Tsai, Thomas C., Ashish K. Jha, Atul A. Gawande, Robert S. Huckman, Nicholas Bloom, and Raffaella Sadun. "Hospital Board and Management Practices Are Strongly Related to Hospital Performance on Clinical Quality Metrics." Health Affairs 34, no. 8 (August 2015): 1304–1311.
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About The Authors

Robert S. Huckman

Technology and Operations Management
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Raffaella Sadun

Strategy
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  • Multitasking While Driving: A Time Use Study of Commuting Knowledge Workers to Assess Current and Future Uses By: Thomaz Teodorovicz, Andrew L. Kun, Raffaella Sadun and Orit Shaer
  • Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use By: A Jay Holmgren, Lance Downing, Mitchell Tang, Christopher Sharp, Christopher Longhurst and Robert S. Huckman
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