Implementation of hospital governing boards: views from the field

• Published in: BMC health services research 2014-04, Vol.14 (1), p.178-178, Article 178
• Main Authors: McNatt, Zahirah, Thompson, Jennifer W, Mengistu, Abraham, Tatek, Dawit, Linnander, Erika, Ageze, Leulseged, Lawson, Ruth, Berhanu, Negalign, Bradley, Elizabeth H
• Format: Article
• Language: English
• Subjects: Analysis; Boards of directors; Chairpersons; Community; Cross-Sectional Studies; Data collection; Decentralization; Developing countries; Ethiopia; Financial management; Governing Board - organization & administration; Guideline Adherence; Health care policy; Health Care Reform; Hospital Administration; Hospitals; Hospitals - standards; Human resource management; Humans; Interviews; LDCs; Low income groups; Methods; NGOs; Nongovernmental organizations; Outsourcing; Patient Satisfaction; Performance management; Professional Role; Public health; Strategic planning; Surveys and Questionnaires
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/1472-6963-14-178

Decentralization through the establishment of hospital governing boards has been touted as an effective way to improve the quality and efficiency of hospitals in low-income countries. Although several studies have examined the process of decentralization, few have quantitatively assessed the implementation of hospital governing boards and their impact on hospital performance. Therefore, we sought to describe the functioning of governing boards and to determine the association between governing board functioning and hospital performance. We conducted a cross-sectional study with governing board chairpersons to assess board (1) structure, (2) roles and responsibilities and (3) training and orientation practices. Using bivariate analysis and multivariable regression, we examined the association between governing board functioning and hospital performance. Hospital performance indicators: 1) percent of hospital management standards met, measured with the Ethiopian Hospital Reform Implementation Guidelines and 2) patient experience, measured with the Inpatient and Outpatient Assessment of Healthcare surveys. A total of 92 boards responded to the survey (96% response rate). The average percentage of EHRIG standards met was 58.1% (standard deviation (SD) 21.7 percentage points), and the mean overall patient experience score was 7.2 (SD 2.2). Hospitals with greater hospital management standards met had governing boards that paid members, reviewed performance in several domains quarterly or more frequently, developed new revenue sources, determined services to be outsourced, reviewed patient complaints, and had members with knowledge in business and financial management (all P-values