Healthcare Governance

Time for a revamp

Corporate governance structures across businesses are witnessing a sea change with hierarchies and egos being sacrificed for efficiencies. This change has been abetted by factors such as globalisation and growing consumer awareness. Organisations have realised the need to change and their leaders are working towards creating governing structures that recognise the importance of feedback from their frontline staff. The healthcare sector, on the other hand, has been a laggard in adopting this change. Hospitals continue to follow age-old practices as governing structures remain top-down in nature restricting the creation of a transparent and accountable organisation.

Hospitals and doctors do a remarkable service to the society, they save lives. What this also means is that all the possible man-made errors have to be avoided as they can prove to be fatal. Medical science has made rapid progress in the last decade. Further, the advent of Information Technology has changed the face of healthcare delivery. Unfortunately, this progress has not been accompanied by similar improvements in patient safety. Reporting of important data (such as wrong medication, injury and infection rates) does not seem to be making it to the ‘top priorities’ list of the board. As a result, medical errors go largely unnoticed and unaccounted for. This scenario can be changed only if the governing board takes the initiative. Provided with the right data, the board can take decisions that make a huge difference to the healthcare quality and patient safety.

Our cover story this time deals with this very issue. In the article, Yosef Dlugacz, Chief of Clinical Quality, Education and Research at the Krasnoff Quality Management Institute, USA, provides valuable insights on the role of the governing body in creating a feedback mechanism that results in the right data getting transmitted to the decision makers. The article brings to fore the importance of the human factor in the functioning of a hospital and improving quality outcomes.

At a time when competition in the healthcare sector is picking up and the consumer is asking for better care, hospitals cannot afford to continue functioning this way. Therefore, the importance of the top management in hospitals is going beyond mere administrative activities. The effort to make data available asks for the active involvement and participation of each and every employee of the organization. It’s for the governing board to recognise the importance of having the data and create an environment where employees participate actively in the syndication of data. For this to happen, the traditional top-down approach to governance needs to be done away with and replaced by a structure that gives importance to the patient and not the hierarchy. This, of course, involves a considerable investment of time, effort and money. The final outcome of this effort would, to a great extent, depend on how well the management is able to ‘sell’ the concept to the employees of the organisation.

It makes considerable business sense to the hospitals. As the medical errors are brought under control, the quality of care improves. This in turn helps in attracting more number of patients. Of late, some positive signs have emerged. The number of hospitals in Asia opting for international quality accreditations has increased with most of them being private sector hospitals. For hospitals across Asia, a transparent and accountable governance structure is the need of the hour. The importance of this need not be emphasised more in an industry where patients trust doctors with their lives.