Hospital boards can promote quality improvement

An evidence-based measure of QI “maturity”


Hospital boards play an important role in quality improvement (QI), and now researchers in England have developed a framework they can use to help develop their QI capability by comparing 15 health care organizations.

“We already know that certain board practices are associated with higher quality care,” said lead researcher Lorelei Jones, PhD. “For example, hospital boards that regularly review quality performance have better patient outcomes. But we don’t know a lot about what boards actually do, or what ‘good’ looks like in relation to quality governance. There is a lot of guidance for boards on what they should be doing, but very little research evidence.”

In their study, researchers developed an evidence-based measure of QI “maturity” – how developed boards were in how they led and oversaw quality improvement. They applied this measure to various organizations and then looked at the characteristics of organizations that showed a highly developed approach to QI.

“Organizations with higher levels of QI maturity prioritized QI; balanced attention to short-term (external) priorities with a long-term (internal) investment in QI; used data for quality improvement, not just quality assurance; engaged staff and patients in QI; and had a culture of continuous improvement,” Dr. Jones said. These characteristics often seemed to be facilitated by clinical leaders; the study also highlighted the importance of board-level clinical leaders in hospitals, she said.

Researchers found that organizations with a highly developed approach to QI did the following:

  • Brought in-depth knowledge and understanding of quality issues and provided the board with meaningful analyses of data.
  • Contributed knowledge of relevant developments in national policy and links to external networks.
  • Played an important role as “boundary spanners,” providing a link between “the board and the ward,” making connections between sources of data and aligning external demands with internal priorities.


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