Harvard School of Public Health, Boston, MA, USA.
Health Aff (Millwood). 2013 Apr;32(4):677-85. doi: 10.1377/hlthaff.2012.1060.
There is growing international interest in the role that hospital boards of directors play in improving the quality of health care. In England the National Health Service created a program to help boards become more effective at ensuring quality. We sought to evaluate how boards at English hospitals are engaged in quality, and we conducted the first national survey of the governance practices of the chairpersons of English hospitals. The survey was completed by 132 of 171 board chairs. We compared the results to those of a survey of the chairs of US hospital boards that we published in 2010. We found that English board chairs had more expertise in quality-of-care issues and spent a greater proportion of their time on quality of care than their US counterparts. At the same time, the association in England between hospital performance on quality metrics and board engagement in quality was generally not as substantial as was evident in our earlier US survey. English board chairs tend to greatly overestimate the quality performance of their hospitals, much as their US counterparts do. Our analysis suggests that there is room for improvement in both countries to bolster board expertise and focus on key quality metrics, and to hold managers accountable for the delivery of safe, effective health care.
医院董事会在提高医疗质量方面的作用越来越受到国际关注。在英国，国民保健制度设立了一个项目，以帮助董事会在确保质量方面更加有效。我们试图评估英国医院的董事会在质量方面的参与程度，并对英国医院主席的治理实践进行了首次全国性调查。调查完成于 171 位董事会主席中的 132 位。我们将结果与我们在 2010 年发表的美国医院董事会主席调查结果进行了比较。我们发现，英国董事会主席在医疗质量问题上拥有更多的专业知识，并且他们花在医疗质量上的时间比例高于美国同行。与此同时，英国医院在质量指标上的表现与董事会在质量方面的参与之间的关联，并不像我们之前的美国调查那样明显。英国董事会主席往往会大大高估其医院的质量表现，就像他们的美国同行一样。我们的分析表明，两国都有改进的空间，可以加强董事会的专业知识，关注关键的质量指标，并要求管理人员对提供安全有效的医疗保健负责。
