Abstract
IntroductionChanging health care systems and market competition requires hospital boards to shift their focus towards a systematic governance of the quality of care. The objective of our study was to describe hospital governance and the quality orientation in the Netherlands. Also we wished to investigate the relationship with hospital performance. Materials and methodsThe chairs of both the boards of trustees and the management boards from all 97 Dutch hospitals were asked to participate in a cross-sectional study between November 2010 and February 2011. In this period data on their quality orientation were collected using a web-based survey. Data on hospital performance over the year 2010 were obtained in July 2011. ResultsA mixture of reforms and national guidelines increased the emphasis on quality governance in Dutch hospitals. Our results show that boards of trustees and management boards had a reasonable quality orientation. Boards were familiar with quality guidelines, received a reasonable amount of information related to quality and used this for monitoring quality and policy-making. However, we found no association between their quality orientation and hospital performance. ConclusionThere was a growing awareness of the quality of care among boards of trustees and management boards; yet some boards still lagged behind. Quality orientation is an important asset because receiving, reviewing and responding to the quality of their performance should provide opportunities to improve quality. However, we were not able to find a relationship between quality orientation and hospital performance. Future research should investigate how boards can develop quality management systems which in turn could enable medical professionals to optimise their delivery of care and thus its quality.
Highlights
Changing health care systems and market competition requires hospital boards to shift their focus towards a systematic governance of the quality of care
Since these scandals still seem to occur due to failing hospital governance, we investigated how hospital governance in the Netherlands has taken shape and to what extent hospital boards are orientated towards quality
In the decentralised health care system, the governmental inference gradually decreased since the 80s, requiring internal oversight bodies, the boards of trustees, to increasingly challenge and support hospital management boards
Summary
Changing health care systems and market competition requires hospital boards to shift their focus towards a systematic governance of the quality of care. In the Netherlands, the management board in the Scheper Hospital in Emmen did not monitor the quality of care properly, which allowed a dysfunctioning hospital consultant to continue to endanger patient safety [3] Another example is the emergence of hospital bacterial infection at the Maasstad Hospital in Rotterdam, which was able to occur partially because both the hospital's management board and its board of trustees lacked a sufficient focus on the quality of care [4]. Since these scandals still seem to occur due to failing hospital governance, we investigated how hospital governance in the Netherlands has taken shape and to what extent hospital boards are orientated towards quality. By reviewing quality performance trustees can improve quality because it provides an insight into what is required
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