Hospital boards that pay closer attention to quality run better hospitals, study finds

Successful boards spent more meeting time discussing quality and performing and held more frequent performance reviews with middle management, according to Health Affairs study.

Management matters in producing higher quality clinical care, a new Health Affairs study claims.

The study, published in the journal's August issue, found that hospital boards that paid greater attention to clinical quality had a direct effect on management doing a better job of monitoring performance, target setting and operations.

Boards that more effectively focused on these aims tied CEO pay to quality performance, the study stated.

Successful boards spent more meeting time discussing quality and performing and held more frequent performance reviews with middle management, according to the study.

[Also: Health Affairs report pokes holes in hospital pay-for-performance programs]

What remains unanswered in the analyses is whether boards influence management or vice versa.

In linking value-based reimbursement and quality, policy makers have traditionally focused on processes and outcomes of clinical providers.

The Health Affairs findings have exposed the dynamic between boards and front-line management in the quality of care.

Several previous studies have shown this association but have not clearly shown which specific activities affect quality of care, the authors said.

High-quality hospitals were more likely to have better management processes related to operations, monitoring, target setting, and human resources than low-quality hospitals, it stated.

Teaching hospitals were also found to be related to better management scores, according to the study. The authors speculated this may reflect a greater commitment to quality because of higher standards expected of these hospitals.

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The study sampled 103 acute care hospitals in the United States and England.

On a scale of 1 to 5, the average overall management score for the sample was 2.85.

Hospitals with management scores above the median were more likely to be teaching hospitals -- 33.3 percent versus 14.3 percent.

These hospitals also had a higher board quality focus and were more likely to use performance on quality metrics to evaluate hospital chief executives -- 62.7 percent versus 41.7 percent.

Twitter: @SusanMorseHFN