It’s a Journey, Not a Destination
As with any effort at improvement, enhancing a board’s effectiveness in being accountable for and knowledgeable about the safety and quality of patient care should be viewed as an ongoing process. The key to any successful journey involves knowing where you are starting from and building a map of where you want to go. While there are an increasing number of practices around quality oversight there are few universally-recognized “best practices” to follow. Therefore, each board should consider its current practices around quality and safety and determine the best process for fulfilling its oversight responsibilities given its individual circumstances.
Boards and board members are encouraged to engage in education, training, and conversation among colleagues. The best environment for quality improvement is one of honest inquiry and data-driven dialogue.
Success in this arena will require boards to become comfortable with uncertainty. The board will never know everything there is to know about patient quality and safety in their organizations. However, smart boards can stay engaged, ask good questions, and support the staff as they work on this critically important effort. Furthermore, the fact that many board members are not clinicians or possess health care expertise can be an advantage; health care is incredibly complex and at times those who work in it may fail to see the forest for the trees. Like the little child in the parable of the Emperor’s New Clothes, board members can ask the seemingly obvious questions and, at times, help reorient an organization’s focus.