Framework

Effective leadership is essential if hospitals are to make the system-level changes that will dramatically improve quality of care and patient safety.  Hospital leadership must be skilled at articulating a vision for quality improvement; cultivating change leaders within their organizations; aligning incentives across administrative, medical and clinical staffs; and managing all aspects of change.  Development of these leadership skills is crucial if hospitals are to “raise the bar” of hospital performance. 

Major Initiatives

Current initiatives in healthcare leadership include:

Leadership Leverage Points.   The Institute for Healthcare Improvement (IHI) has defined seven leadership leverage points for improvement of healthcare at the organization level.  These seven points were developed from observations made as part of their work supporting leaders in innovative healthcare organizations.  The leverage points represent the areas in which IHI believes that hospital leadership must focus their attention if they are to bring about system-level performance improvement. 

Health Leadership Competency Model.  The National Center for Healthcare Leadership’s Health Leadership Competency Model was developed with the goal of improving the country’s health status by increasing the effectiveness of our healthcare leaders.  The model establishes core competencies for healthcare leaders (administrative, medical, and clinical) at all stages of the career cycle.  These competencies are the technical and behavioral characteristics that successful healthcare leaders possess.  The model can be used to focus training and development initiatives for healthcare leaders.

Physician Engagement.   There is a growing recognition of the importance of cultivating physician engagement in all aspects of hospital governance if hospitals are to make significant improvements in quality of care and patient safety.  Hospital executives must overcome barriers to physician participation such as time constraints, lack of relevance to the physician’s practice, and lack of compensation, while actively managing the risks associated with physician involvement in the work of hospital boards.   Adopting strategies of openness and engagement can minimize risks and enhance hospital performance. 

Involvement of Governance.  Focusing Board attention on quality and patient safety issues can help drive cultural change.  What a Board chooses to monitor and act upon becomes important to the entire organization.  To support the quality improvement efforts of hospital leadership, Boards will first need to educate themselves about quality and safety.  They may choose to link compensation of key leadership to achievements in these areas, requiring the creation and monitoring of key quality measures to ensure progress. 

Key Questions

Key questions that hospital leaders should be discussing within their organizations include the following:

1.  What is the role of the CEO in quality and patient safety improvement?

2.  How can we make quality and patient safety meaningful to our governing board?

3.  How can we set priorities for quality and patient safety improvement?

4.  How can we incorporate our organization’s priorities and goals in quality and patient safety into leadership development programs and opportunities?