Quality of care is often not a top priority for nonprofit hospital boards, according to results of a Harvard School of Public Health survey of board chairs in Health Affairs.

Board chairs were asked to rank their top two priorities from six issues—quality of care, financial performance, operations, business strategy, patient satisfaction and community benefit—for board oversight and for evaluating CEO performance.

Respondents from 44 percent of hospitals chose clinical quality as one of the top two priorities for evaluating CEO performance. Chairs from high-performing organizations (determined by Hospital Quality Alliance data) selected quality twice as often as chairs from low-performing institutions did. Other choices for top priorities for board oversight and CEO evaluation were financial performance (70 percent of high performers versus 75 percent of low performers); operations (13 percent versus 42 percent); business strategy (27 percent versus 20 percent); patient satisfaction (27 percent versus 21 percent), and community benefit (20 percent versus 8 percent).

Other findings included:

  • Quality performance is on the agenda for every board meeting in 63 percent of hospitals. Financial performance is on every agenda in 93 percent of hospitals.
  • Ninety-one percent of high-performing hospitals regularly reviewed a quality dashboard, compared with 62 percent of low-performing hospitals.
  • Twenty percent of respondents reported that the chair, the board or one of the board's committees was one of the two most influential quality forces in the hospital.
  • Sixty-nine percent reported that the CEO was one of two entities with the greatest influence on quality.

For more information, go to www.healthaffairs.org.