Laboratory of Health Sciences and Technology, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco.
Faculty of Science and Technology Settat, Hassan 1st University, Settat, Morocco.
Int J Health Care Qual Assur. 2024 Nov 14;ahead-of-print(ahead-of-print):25-41. doi: 10.1108/IJHCQA-09-2023-0065.
This paper aims to contribute to the existing literature in the field of hospital governance by exploring the relationship between the attributes and performance of hospital boards and hospital performance in terms of quality of healthcare.
DESIGN/METHODOLOGY/APPROACH: A survey of board performance in public hospitals in Morocco was carried out, in which we surveyed all board members of the 13 hospitals in the Casablanca-Settat region. A total of 82 members responded (82% response rate) to the previously adapted and validated self-evaluation questionnaire on board self-assessment questionnaire (BSAQ) board member performance.
On average, the hospital boards studied had eight members. In terms of clinical expertise, half the members were physicians and 17% were nurses. In addition, positive correlations were found between certain board characteristics, notably age, seniority, members' perceptions of their impact on the quality of healthcare and several dimensions of board performance. In parallel, the results showed strong and significant associations between turnover rate and BSAQ score. Negative correlations were also found between average length of stay and BSAQ score. With regard to mortality parameters, it should be noted that we were unable to establish a strong empirical correlation between hospital boards' self-assessed performance and other hospital mortality indicators.
RESEARCH LIMITATIONS/IMPLICATIONS: The present study offers a rigorous rationale for the use of the French-translated BSAQ in the hospital context, and we hope that others will use this tool in future work within the framework of evidence-based research. In addition, the BSAQ tool's focus on board competencies (and not just structure, composition or processes) provides valuable insights into what boards need to learn in order to function effectively. However, despite the insistence of the authors of this study on the need for a comprehensive census of public hospital board members in the region, several obstacles were encountered. Firstly, there were difficulties related to vacancies within the hospitals, which had the effect of restricting the representativeness of the sample. Secondly, access to hospital board members proved complex due to their busy schedules and the confidential nature of their meetings. Finally, it is important to note that national performance indicators in Morocco may not be as reliable as in other countries, which could complicate the identification of high-performing hospital systems and, consequently, make inference difficult.
ORIGINALITY/VALUE: This study provides large-scale empirical evidence of processes related to the governance of quality of healthcare and elucidates the existence of an association between hospital board performance and clinical performance. The use of validated tools such as the BSAQ should therefore help improve the performance of boards and governance in public hospitals.
本文旨在为医院治理领域的现有文献做出贡献，探讨医院董事会的属性和绩效与医院在医疗质量方面的绩效之间的关系。
设计/方法/途径：对摩洛哥公立医院的董事会绩效进行了调查，我们对卡萨布兰卡-塞塔特大区的 13 家医院的所有董事会成员进行了调查。共有 82 名成员（82%的回复率）对之前经过改编和验证的董事会自我评估问卷（BSAQ）进行了回答。
在所研究的医院董事会中，平均每个董事会有 8 名成员。在临床专业知识方面，一半的成员是医生，17%是护士。此外，还发现某些董事会特征之间存在正相关关系，特别是年龄、任期、成员对其对医疗质量的影响的看法以及董事会绩效的几个维度。同时，结果表明董事会成员更替率与 BSAQ 评分之间存在很强的显著关联。平均住院时间与 BSAQ 评分之间也存在负相关关系。关于死亡率参数，应该注意的是，我们无法在医院董事会自我评估绩效与其他医院死亡率指标之间建立强有力的经验关联。
研究局限性/影响：本研究为在医院环境中使用法语翻译的 BSAQ 提供了严格的理由，我们希望其他人在循证研究框架内使用该工具进行未来的工作。此外，BSAQ 工具的重点是董事会的能力（而不仅仅是结构、组成或流程），为董事会需要学习什么以有效运作提供了有价值的见解。然而，尽管本研究的作者坚持认为需要对该地区的公立医院董事会成员进行全面普查，但还是遇到了一些障碍。首先，医院内部存在职位空缺，这限制了样本的代表性。其次，由于医院董事会成员日程繁忙且会议内容保密，因此很难接触到他们。最后，需要注意的是，摩洛哥的国家绩效指标可能不如其他国家可靠，这可能会使确定表现出色的医院系统变得复杂，从而使推断变得困难。
原创性/价值：本研究提供了与医疗质量治理相关的过程的大规模经验证据，并阐明了医院董事会绩效与临床绩效之间存在关联。因此，使用 BSAQ 等经过验证的工具应该有助于提高公立医院董事会和治理的绩效。
