1. The Board’s Role in Quality
11/18/2018 2:54 PM
The Board’s Role in Quality

2. The Board has the ultimate responsibility for quality and safety
The Board leads by, working with senior management, to:
Define quality/develop a framework for quality and safety
Ensure that the quality plan flows from the strategic plan
Identify board quality indicators to monitor
Develop its monitoring mechanisms and processes
Be actively involved in committee and board agenda design around quality
Embrace quality and become quality literate
Effective Governance for Quality and Patient Safety Education Program

3. Boards need the following knowledge to oversee progress on an improvement agenda:
Understand Current & desirable organizational performance
Appreciate the Resources required (investments of time and money)
Understand the Risks and challenges that could impede achievement of targets
Recognize the Timeline required for results
Ask good questions!
Two important questions for Board members
to ask is “Why?”
and to continuously question
“How will we know?”

4. Indicate which of the following are considered leading practice for embedding QI knowledge and skill at the Board level?
Practices
True
False
Board members should be recruited using a skills based matrix, including a skill base that includes process improvement, organizational development, and/or performance measurement & management.
Only the members of a Quality Committee need to be educated about and have knowledge about quality improvement and oversight.
The Board orientation program should Include key organizational practices related to quality and safety.
Boards should spend at least as much time (25%) discussing matters pertinent to the quality of service delivery as they spend discussing finances.
The Board should rely on senior management to bring QI expertise to the Board, because it is impossible to expect Board members to have this knowledge.
There is no evidence that demonstrates that a Board’s focus on quality makes any difference to client outcomes.

5. Key questions for Board members to ask once a year when developing the QIP
How good are our services?
How do we compare to others
like us?
How much of a gap is there between our current and desired performance?
Why does the gap exist and what is our plan to close the gap?
How much variation is there among our providers?
AIM
MEASURE
CHANGE
Quality Dimension
Objective
Indicator
Current Performance
Target
Target Justification
Change Idea
Method
Process Measure
Comment

6. Key questions for Board members to ask quarterly when reviewing quality indicators included in the QIP
Are our services getting better?
Are we on track to achieve our
key quality and safety objectives?
If not, why not?
Is the strategy wrong?
Is the strategy insufficient?
Is it not being executed effectively?
Is it too early in the process?
How many clients is that?

7. Additional questions for Board members to ask…
In the industry, what are the key drivers for operational excellence?
What are the intended & unintended consequences of a proposal brought forward by management?
What are risks?
Are there other options?
What if __________?
How will that impact our client outcomes?

8. Additional factors impacting organizational quality that the Board should consider…
How can we ensure continuity of performance excellence through succession planning?
With the trend toward shared accountability and cross- sector integration, what type of partnership discussions should the Board be involved in?
What strategies can the Board use to better understand the operations, without micro-managing?
What tactics can be used to increase time available at Board meetings for discussion on quality and other strategic matters?

9. Once a Board Understands the Content Required in Ontario’s QIPs, what are the Roles and Responsibilities for the Board vs Senior Leadership
The Board
Senior Management
Agree on issues/areas for quality agenda priorities
Articulate SMART Aims to reflect the areas for priority
Populate the Short and Long forms for Board approval
Identify measures, baseline data and aspirational targets
Engage staff in developing an action plan with process measures and appropriate targets to achieve targets on outcomes
Approve the articulation of the quality priorities and the Plan
Outcome measures for focus
Targets on outcome measures
Regularly monitor progress – ask key strategic questions!
Assign Executive Sponsors, regularly monitor progress, problem solve and coach

10. Indicate which of the following roles in developing and executing the QIP should be the Board’s responsibility
Roles
True
False
Determine which outcome indicators and what targets should be included in a Quality Plan.
Agree on the quality priorities that will drive the content of the Quality Plan over 2-3 years.
Approve the final Plan.
Sign off on the final Plan.
Ensure there is an Executive Sponsor assigned to each quality improvement project in the Plan.
Approve the proposed outcome indicators and targets.
Monitor the results on outcome indicators, at least quarterly, by reviewing a scorecard and asking good questions.

11. To Summarize…
The Board leads by, working with senior management to: Define a framework for quality and safety, ensure that the quality plan flows from the strategic plan, agree on quality indicators and monitor regularly, be actively involved in committee and board agenda design, and embrace quality.
With a foundation in quality, one of the key roles for a Board is asking good questions that will help to establish the organization’s quality priorities and oversee progress on improvement.