Hospital Leadership is Key to Quality

A new study confirms that in hospitals, as in other institutions, top management commitment is critical to achieve improvements. And in healthcare, that includes the hospital board.

            That is one of the findings in the study, conducted by Eugene Kroch, Ph.D. He is vice president and director of research for consulting firm CareScience. And he is a senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania, where he also he teaches health economics and econometrics at the Wharton School.

            The study, described in a presentation at the recent conference of theHealthcare Information and Management Systems Society (HIMSS), was based on 438 responses to a survey of hospitals in nine states (Arizona, Colorado, Illinois, Iowa, Maryland, New Jersey, New York, Pennsylvania and Wisconsin). Fifty-five percent of the responses were from CEOs, 25 percent from executives involved in quality improvement, and 13 percent from chief medical or chief nursing officers.

            (This is the first of two postings I’m writing about the survey results. The second will discuss how the hospitals use performance scorecards.)

            Kroch correlated the survey results with data developed by CareScience from several sources about hospital quality, to determine how the responses of the best-quality hospitals were different from all others. He found that better outcomes are associated with hospitals where:

• The board spends more than 25 percent of its time on quality issues.
  
• The board receives a formal quality performance measurement report.
  
• There is a high level of interaction between the board and the medical staff on quality strategy.
  
• Compensation for senior executives is based in part on quality improvement performance.
  
• The CEO is identified as the person with the greatest impact on quality, especially when so identified by the quality improvement executive.

            These findings may come as no surprise to those of us familiar with lean concepts. However, with any luck they may serve as a wake-up call for at least a few of the top executives whose hospitals are not among the best.