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