Bringing the Board of Directors on Board with Quality and Safety of Clinical Care at Temple Street Children’s University Hospital: A case study and Toolkit
High performing hospitals all have one thing in common, effective and active Board engagement, which takes on a decisive role in improving delivery in quality care. Compelling evidence from national and international inquiries into patient care, suggests that Boards that have capable and dedicated leadership at both Board and Executive level focus on quality and improving patient safety.
This case study provides a real-world example of a successful “Board in Action”. The board members changed the way they do business, rebalancing their board meeting agenda to give prominence to quality of care. Using quality improvement methods over approximately two years the board radically changed the approach to oversight and improvements in quality of care.
Co-designed change packages (interventions) include:
- Develop a Board of Directors’ Quality Dashboard and test it over time.
- Develop a Board of Directors written report and test it over time.
- Present and analyse quality indicators using statistical process control methodology.
- Present the written report for consideration by the Board at their monthly meetings.
- Board and project liaison researcher attends the monthly board meetings, observes the reaction of the Board discussions and reports back to the project team for the project life time.
- Provide the Board with an educational session and targeted reading.
- Provide the Board with a cover letter that includes instructions for each month.
- Move quality and safety to the top of the board agenda and make it the first item of the meeting.
- Group all items relating to quality and safety under this agenda item.
- Time the discussion of all items under the quality and safety heading of the agenda.
- Ask a different individual board member (or two) to comment on the Board of Directors’ Quality Dashboard each month.
- Include recommendations from the Board in relation to the Quality Dashboard, in board minute action logs which are reviewed at subsequent meetings.
The project resulted in the identification of quality of care measures specific to children’s services and the first organisation to use Statistical Process Control (SPC) Charts together with a structured report in a Board of Directors’ Quality Dashboard to provide a greater insight into the quality of care provided and opportunities for improvement.
CEO and Chair of the Board of Directors' reflections on their role in improving quality through this initiative
In the video below, Mona Baker (CEO) and Séan Sheehan (Chair of the Board of Directors) of Temple Street Children’s University Hospital share their experiences of how the board engaged in a quality improvement initiative to get a picture of quality of clinical care and how they acted to focus their attention on quality of care.