McDonagh Kathryn J
CHRISTUS Spohn Health System, Corpus Christi, Texas, USA.
J Healthc Manag. 2006 Nov-Dec;51(6):377-89; discussion 390-1.
This article describes the development and evolution of governing boards and summarizes critical findings from a research study on hospital governing boards. The purpose of the research was to examine factors that measure performance of governing boards and the relationship of governing board effectiveness to the organizational performance of hospitals. Board leaders from 64 nonprofit hospitals across the country were surveyed using the BSAQ tool, which measures board effectiveness in six areas of competency. Board competency scores of this group were compared with those of a previous group, which consisted of more than 300 nonprofit boards, and demonstrated significantly higher scores. A factor analysis conducted to compare the six competency factors between study groups revealed a strong single factor in this study. The factors that measure governing board performance were found to be consolidated into one single factor of collaborative board functioning consistent with emerging governance theory. This may support the concept of the importance of governing boards as collaborative, socially dynamic networks of leaders. The hospital performance was assessed using data from the nationally recognized program, Solucient's 100 Top Hospitals. The results demonstrate that higher performing boards did have better hospital performance in several dimensions, most notably in profitability and lower expenses. Lower expenses were related to higher scores for the BSAQ total score. Hospital profitability was positively correlated with all seven BSAQ scores. A more favorable Solucient ranking was related to hospitals that had a lower BSAQ political score. This was also found in a multiple regression model that predicted a favorable ranking when the BSAQ political score was lower. This may mean that these boards do what needs to be done to maintain excellent performance and do not let politics get in the way of their work. Although governance and its effect on hospital performance is a complex concept to study, this investigation yields findings of interest to leaders in the healthcare field.
本文描述了管理委员会的发展与演变，并总结了一项关于医院管理委员会研究的关键发现。该研究的目的是考察衡量管理委员会绩效的因素，以及管理委员会有效性与医院组织绩效之间的关系。使用BSAQ工具对全国64家非营利性医院的委员会领导进行了调查，该工具在六个能力领域衡量委员会有效性。将该组的委员会能力得分与前一组（由300多个非营利性委员会组成）的得分进行比较，结果显示得分显著更高。为比较研究组之间的六个能力因素而进行的因素分析在本研究中揭示了一个强大的单一因素。发现衡量管理委员会绩效的因素被整合为一个与新兴治理理论一致的协作性委员会运作的单一因素。这可能支持了管理委员会作为领导者的协作性、具有社会活力的网络的重要性这一概念。使用来自全国公认的项目Solucient's 100 Top Hospitals的数据评估医院绩效。结果表明，表现较好的委员会在几个维度上确实有更好的医院绩效，最显著的是在盈利能力和较低费用方面。较低的费用与BSAQ总分的较高得分相关。医院盈利能力与所有七个BSAQ得分呈正相关。Solucient排名更靠前与BSAQ政治得分较低的医院有关。在一个多元回归模型中也发现了这一点，该模型预测当BSAQ政治得分较低时排名会更有利。这可能意味着这些委员会会采取必要措施来保持卓越绩效，不让政治妨碍他们的工作。尽管治理及其对医院绩效的影响是一个复杂的研究概念，但这项调查得出了医疗保健领域领导者感兴趣的发现。
