These are excerpts from the recent study in Health Affairs by Thomas Tsai, MD, MPH, a surgeon and health policy researcher in the Department of Surgery at Brigham and Women’s Hospital and in the Department of Health Policy and Management at Harvard School of Public Health in Boston:
- “High-quality hospitals were more likely to have better management processes related to operations, monitoring, target setting, and human resources than low-quality hospitals. Management scores were significantly higher in hospitals with boards that paid greater attention to quality and that were more likely to adopt effective practices related to the use of data on clinical quality metrics. These findings suggest that board and management practices are both strongly related to a hospital’s performance on clinical quality metrics and may provide a unique target for quality improvement interventions reaching across multiple clinical domains.”
- “Our findings have important implications for policy as well as for health systems practice. Federal policy makers have signaled a commitment to accelerating the Affordable Care Act’s (ACA’s) transition to value-based payments by linking the majority of current Medicare fee-for-service reimbursements to quality in the next few years. This has the potential to create new impetus for organizational leaders to improve and ultimately deliver high-quality care. Given the relationship between board and management performance with hospital performance on quality metrics, our findings suggest that there are other important tools that policy makers can use to drive improvements. For hospitals that are struggling with lower quality, encouraging board or management training (or both) might be useful.”
- “Given the recent increase in hospital consolidation, there is also concern that managerial focus has been directed toward expansion instead of internal improvement. Front-line staff and senior managers often have different perceptions of both the goals and results of quality improvement efforts, and the lack of a shared commitment and understanding by hospital leadership and staff may hinder the effectiveness of quality improvement initiatives.”
