Governance of healthcare quality: exploring the relationships between hospital board performance and healthcare quality outcomes

• Published in: International journal of health care quality assurance 2024-11, Vol.37 (3/4), p.25-41
• Main Authors: Mourajid, Yassmine, Chahboune, Mohamed, Ifleh, Abdelhadi, Al Wachami, Nadia, Arraji, Maryem, Boumendil, Karima, Iderdar, Younes, Bouchachi, Fatime Zahra, Hilali, Abderraouf
• Format: Article
• Language: English
• Subjects: Accountability; Adult; Averages; Boards; Boards of directors; Censuses; Clinical governance; Decision making; Dependency theory; Evidence based research; Female; Governing Board - organization & administration; Health care; Hospital Administration; Hospital Mortality; Hospitalization; Hospitals; Hospitals, Public - organization & administration; Hospitals, Public - standards; Humans; Leadership; Length of stay; Male; Managers; Middle Aged; Morocco; Mortality; Nurses; Patient safety; Perceptions; Performance indicators; Quality Indicators, Health Care; Quality of care; Quality of Health Care - organization & administration; Quality of Health Care - standards; Questionnaires; Representativeness; Self evaluation; Seniority; Strategic planning; Surveys and Questionnaires; Vacancies
• ISSN: 0952-6862; 1758-6542
• DOI: 10.1108/IJHCQA-09-2023-0065

PurposeThis paper aims to contribute to the existing literature in the field of hospital governance by exploring the relationship between the attributes and performance of hospital boards and hospital performance in terms of quality of healthcare.Design/methodology/approachA survey of board performance in public hospitals in Morocco was carried out, in which we surveyed all board members of the 13 hospitals in the Casablanca-Settat region. A total of 82 members responded (82% response rate) to the previously adapted and validated self-evaluation questionnaire on board self-assessment questionnaire (BSAQ) board member performance.FindingsOn average, the hospital boards studied had eight members. In terms of clinical expertise, half the members were physicians and 17% were nurses. In addition, positive correlations were found between certain board characteristics, notably age, seniority, members' perceptions of their impact on the quality of healthcare and several dimensions of board performance. In parallel, the results showed strong and significant associations between turnover rate and BSAQ score. Negative correlations were also found between average length of stay and BSAQ score. With regard to mortality parameters, it should be noted that we were unable to establish a strong empirical correlation between hospital boards' self-assessed performance and other hospital mortality indicators.Research limitations/implicationsThe present study offers a rigorous rationale for the use of the French-translated BSAQ in the hospital context, and we hope that others will use this tool in future work within the framework of evidence-based research. In addition, the BSAQ tool’s focus on board competencies (and not just structure, composition or processes) provides valuable insights into what boards need to learn in order to function effectively. However, despite the insistence of the authors of this study on the need for a comprehensive census of public hospital board members in the region, several obstacles were encountered. Firstly, there were difficulties related to vacancies within the hospitals, which had the effect of restricting the representativeness of the sample. Secondly, access to hospital board members proved complex due to their busy schedules and the confidential nature of their meetings. Finally, it is important to note that national performance indicators in Morocco may not be as reliable as in other countries, which could complicate the identification