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How Good are You? Do You Know? Questions for the Board

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Excerpt from the Compass Clinical Consulting Profile in Healthcare Leadership “Building the Will to Quality Care,” with Maureen Bisognano, CEO of the Institute for Healthcare Improvement. Ms. Bisognano was named one of “The Top 25 Women in Healthcare for 2011” by Modern Healthcare Magazine, is a prominent authority on improving healthcare systems, and advises healthcare leaders around the world. She is also a frequent speaker at major healthcare conferences on quality improvement and is an Instructor of Medicine at Harvard Medical School.

Compass Clinical Consulting’s “Profiles in Healthcare Leadership” are the result of interviews with transformational leaders in today’s healthcare industry—men and women who have demonstrated courage, ingenuity and the hard work needed to create dramatic, measurable and sustainable improvements in their hospitals. These leaders challenge assumptions, see things differently and enable remarkable breakthroughs. These leaders freely convey insights that we all can use to improve the way we deliver healthcare, and in the process, give us new ideas on how to make better American hospitals.

WILL, NEW IDEAS, EXECUTION

(CCC): One of the key things for the Board to do is to create the motivation within the organization to deeply understand, act and finish an initiative.  Finishing is critical if you are going to make a positive change within the organization.

Maureen Bisognano (MB): Absolutely. At IHI, we always say you need three things to improve: will, new ideas, and exquisite execution skills.

It starts with building will, and I do think that’s a part of the Board’s role. When I meet with Boards or executive teams, I ask these four will-building questions.

1. How good are you?  Do you know?

Are you reliant on a static red, yellow, green scorecard, or are you looking at data over time in a balanced scorecard view?

2. Do you know where your variation exists?

Why ask this? Because within that average number that Boards always look at, hides exceptional performance. The average hides both good and bad performance—exceptionally good and exceptionally bad sometimes.

When the Board starts to look at that variation, it gives them real insight into what the role of governing is. To remove that variation, you need the poor performers learning from the better.

3. Where does your organization stand relative to the best?

Often they have no idea.

They look at their own performance, but they don’t know that there is a gap between what they see on their quality data and what the best are doing within their county, system, state, country or around the world. That gap can be profoundly moving for Boards.

4. Do you look at your rate of improvement over time?

I could give any hospital in the United States—any adult hospital—their mortality data since 1998. Many of them think they are improving. But … when they actually look at their data, they might not be. They may be flat or could be improving dramatically.

It’s looking at performance over time that is so critical for Boards.

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This “Building the Will to Quality Care” (click on the link to access) profile features Maureen Bisognano, President, and CEO of The Institute for Healthcare Improvement (IHI). Ms. Bisognano was named one of “The Top 25 Women in Healthcare for 2011” by Modern Healthcare Magazine. She is a prominent authority on improving healthcare systems, and this expertise has been recognized by her elected membership to the Institute of Medicine and by her appointment to The Commonwealth Fund’s Commission on a High-Performance Health System, among other distinctions. Ms. Bisognano advises healthcare leaders around the world, is a frequent speaker at major healthcare conferences on quality improvement and is a tireless advocate for change. She is also an Instructor of Medicine at Harvard Medical School, a Research Associate in the Brigham and Women’s Hospital Division of Social Medicine and Health Inequalities, and serves on the Boards of the Commonwealth Fund, ThedaCare Center for Healthcare Value, and Mayo Clinic Health System in Eau Claire

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