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Transforming health care through research and education.

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Leveraging research and education to create a society of healthy communities, where all individuals reach their highest potential for health.

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Short Survey on Governance: Physician-Board Engagement

To get a better sense of how hospital boards interact with physicians and exercise their oversight of clinical operations, Trustee magazine, the Health Research & Educational Trust, and the Center for Healthcare Governance surveyed CEOs and board chairs. Two hundred fifty-eight responded to this survey during the fall of 2006. The results by and large showed that boards are confident about their ability to oversee and approve medical staff credentialing and that major conflicts between hospitals and medical staffs over credentialing are infrequent.

Boards are paying increasing attention to quality, with large majorities agreeing that most trustees are literate in patient safety and quality and that their boards have worked with their medical staffs to improve patient safety and quality of care over the last 3 years.

Physicians play different roles in interpreting quality data for the board, including providing leadership and technical expertise. Boards encourage physicians to provide leadership in quality improvement in many ways, including by establishing clinical quality teams. Still, physicians are more often selected for board membership on the basis of their role in the organized medical staff than for their quality expertise.

Hospitals also are increasingly going into business with physicians. Around half (51%) have entered into or are planning joint ventures with physicians for clinical services. Most of those joint ventures are for outpatient services, with very few collaborating on specialty hospitals. Another rare practice is sharing savings from improvements in clinical efficiency and quality.

Overall, boards are engaged in providing oversight to the hospital-MD relationship. Three-quarters approve some or all contracts between the hospital and physicians, and 68 percent have policies that define conflict of interest between medical staff members and the hospital.

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