ArticleBMJ quality & safety2017
How do hospital boards govern for quality improvement? A mixed methods study of 15 organisations in England.
Article in BMJ quality & safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis.The Cochrane database of systematic reviews · 2023Pooled it
- Shared clinical governance arrangements between NHS and independent acute hospitals in England: Findings from a national survey of senior leaders.Journal of health services research & policy · 2026Article
- Evaluating the Impact of Short-Notice Accreditation Assessment on Hospitals' Patient Safety and Quality Culture: Protocol for a Mixed Methods Study.JMIR research protocols · 2026Article
- Effects of Implementing an ICU Discharge Readiness Checklist onHealthcare (Basel, Switzerland) · 2025Article
- Understanding and measuring workplace violence in healthcare: a Canadian systematic framework to address a global healthcare phenomenon.BMC emergency medicine · 2025Article
- Core elements of excellent hospital leadership: lessons from the five top-performing hospitals in China.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Article
- Using Healthcare Failure Mode and Effect Analysis in prospective medication safety risk management in secondary care inpatient wards.European journal of hospital pharmacy : science and practice · 2024Article
- Hospital governance accountability structure: a scoping review.BMC health services research · 2024Article
- Organizational attributes that contribute to the learning & improvement capabilities of healthcare organizations: a scoping review.BMC health services research · 2023Article
- Role of medical leaders in integrated care systems: what can be learnt from previous research?BMJ leader · 2023Article
- National statutory reporting: not even ticking the boxes? The quality of 'Learning from Deaths' reporting in quality accounts within the NHS in England 2017-2020.BMJ open quality · 2023Article
- The Special Measures for Quality and Challenged Provider Regimes in the English NHS: A Rapid Evaluation of a National Improvement Initiative for Failing Healthcare Organisations.International journal of health policy and management · 2022Article
- Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study.International journal of health policy and management · 2022Observational
- What Does a Systems Approach to Quality Improvement Look Like in Practice?International journal of environmental research and public health · 2022Article
- Ethnographic research as an evolving method for supporting healthcare improvement skills: a scoping review.BMC medical research methodology · 2021Article
- Implementing a novel programme for nurses and allied health professionals to develop capacity for evidence-informed clinical practice.Journal of research in nursing : JRN · 2021Article
- Article
- The role of professional elites in healthcare governance: Exploring the work of the medical director.Social science & medicine (1982) · 2021Article
- Countries' experiences in reforming hospital administration structure based on the Parker and Harding model: A systematic review study.Journal of education and health promotion · 2021Review
- Mapping clinical governance to practitioner roles and responsibilities.Journal of health organization and management · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth systems worldwide are increasingly holding boards of healthcare organisations accountable for the quality of care that they provide. Previous empirical research has found associations between certain board practices and higher quality patient care; however, little is known about how boards govern for quality improvement (QI).
methodsWe conducted fieldwork over a 30-month period in 15 healthcare provider organisations in England as part of a wider evaluation of a board-level organisational development intervention. Our data comprised board member interviews (n=65), board meeting observations (60 hours) and documents (30 sets of board meeting papers, 15 board minutes and 15 Quality Accounts). We analysed the data using a framework developed from existing evidence of links between board practices and quality of care. We mapped the variation in how boards enacted governance of QI and constructed a measure of QI governance maturity. We then compared organisations to identify the characteristics of those with mature QI governance.
resultsWe found that boards with higher levels of maturity in relation to governing for QI had the following characteristics: explicitly prioritising QI; balancing short-term (external) priorities with long-term (internal) investment in QI; using data for QI, not just quality assurance; engaging staff and patients in QI; and encouraging a culture of continuous improvement. These characteristics appeared to be particularly enabled and facilitated by board-level clinical leaders.
conclusionsThis study contributes to a deeper understanding of how boards govern for QI. The identified characteristics of organisations with mature QI governance seemed to be enabled by active clinical leadership. Future research should explore the biographies, identities and work practices of board-level clinical leaders and their role in organisation-wide QI.
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