A Governing Board’s Role in Quality, Safety, Service, and Access to Care

A governing board is just as responsible for quality, safety, service, and access to care as it is for financial performance. The table below gives examples of how a Board can effectively ensure high quality and patient safety for its organization. 

Key Strategies to Improve Organizational Quality
Communicate the board’s commitment to quality and safety to patients, physicians, employees, community partners and the public  
Put patient safety and quality on every board meeting agenda
Review quality measurements, discuss benchmarks, and discuss corrective action plans for poor quality or adverse events
Create momentum for improvement and build organizational will to achieve certain results
Link quality outcomes to the CEO’s evaluation and compensation
Uphold evidence-based practices and ensure compliance with preventative care recommendations
Assure sufficient resources are dedicated for quality and safety including but not limited to data collection, staff training, survey readiness (accreditation), and patient engagement
Ask questions about quality and safety at every board meeting
Discuss quality and safety standards related to staff and facilities in addition to services
Monitor quality and safety indicators and the progress to achieve performance goals


Ensuring high quality and patient safety is not only the right thing to do but also has financial implications. Healthcare systems, independent hospitals, and providers can all be affected financially by quality metrics, either to their benefit or detriment. A Board needs to understand key quality benchmarking measures such as the CMS Star Rating or Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores to compare their organizational quality and services with those of others within the market. As the healthcare payment system continues to evolve, the future value equation will be as follows:

Value = (Quality/Cost) * Population

Within this model, health systems will derive value from increasing quality while lowering costs and distributing that value across a population. This means that while Boards should be concerned with fiscal responsibility, they should be equally concerned with Quality.

Those who serve on the Boards of organizations that provide care for our communities, whether it be a health system, rural independent hospital, federally qualified health center (FQHC), or other, have been called to ensure that their community members can access healthcare services at their time of greatest need. While the financial viability of these organizations is critically important, organizational quality is an equally vital strategic pillar because it represents how well we are serving those who need us the most.