Hospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence

Article


Millar, R., Freeman, T. and Mannion, R. 2015. Hospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence. BMC Health Services Research. 15 (1). https://doi.org/10.1186/s12913-015-0771-x
TypeArticle
TitleHospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence
AuthorsMillar, R., Freeman, T. and Mannion, R.
Abstract

Background: Hospital boards, those executive members charged with developing appropriate organisational strategies and cultures, have an important role to play in developing the safety of these organisations. However, recent attention has been drawn to boards’ ability to enact their duty to ensure the quality and safety of care. This paper offers critical reflection on the relationship between hospital board oversight and patient safety. In doing so it highlights new perspectives and suggestions for developing this area of interest.
Methods: the article draws on a series of 10 interviews with key informants and policy actors who form part of the ‘issue network’ interested in the promotion of patient safety in the English National Health Service.
Results: the interviews surfaced a series of narratives regarding hospital board oversight of patient safety. These elaborated and refined the theoretical perspectives trust and intelligence in highlighting the potential dangers and limitations of approaches to hospital board oversight which have been narrowly focused on a risk-based view of organisational performance. In response, a need to engage with the development of trust based organisational relationships is identified, in which effective board oversight is built on ‘trust’ characterised leadership styles and behaviours attentive to the needs and concerns of both staff and patients. Effective board oversight also requires the gathering and triangulating of ‘intelligence’ from both national and locally generated information sources.
Conclusions: We call for a re-imagination of hospital board oversight in the light of these different perspectives and anticipate an emerging research agenda in this area.

KeywordsBoards; Quality; Patient Safety; Trust; Intelligence
LanguageEnglish
PublisherBMC
JournalBMC Health Services Research
ISSN
Electronic1472-6963
Publication dates
Online16 Jun 2015
PrintDec 2015
Publication process dates
Deposited01 May 2015
Accepted27 Feb 2015
Submitted23 Jul 2014
Output statusPublished
Publisher's version
License
Copyright Statement

© 2015 Millar et al. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Digital Object Identifier (DOI)https://doi.org/10.1186/s12913-015-0771-x
Scopus EID2-s2.0-84935891365
Web of Science identifierWOS:000356480700001
Permalink -

https://repository.mdx.ac.uk/item/853v6

Download files

  • 36
    total views
  • 4
    total downloads
  • 0
    views this month
  • 0
    downloads this month

Export as

Related outputs

Self-surveillance practices of factory women migrant workers receiving SRH interventions in Malaysia: The effects of salience, gendered subjectivity and universalism
Freeman, T., Miles, L. and Ying, K. 2024. Self-surveillance practices of factory women migrant workers receiving SRH interventions in Malaysia: The effects of salience, gendered subjectivity and universalism. Economic and Industrial Democracy. https://doi.org/10.1177/0143831X231225098
Migrant workers navigating the Covid-19 pandemic in the UK: Resilience, reworking and resistance
Miles, L., Freeman, T., Polzin, A., Reitz, R. and Croucher, R. 2023. Migrant workers navigating the Covid-19 pandemic in the UK: Resilience, reworking and resistance. Economic and Industrial Democracy. https://doi.org/10.1177/0143831X231199874
A handbook to support the sexual and reproductive health needs of factory women migrant workers
Miles, L., Endut, N., Freeman, T., Ying, K., Lai, W. and Mat-Yasin, S. 2022. A handbook to support the sexual and reproductive health needs of factory women migrant workers. Pulau Pinang, Malaysia Unit for Research on Women and Gender (KANITA), Universiti Sains Malaysia.
Empowerment as a pre-requisite to managing and influencing health in the workplace: the sexual and reproductive health needs of factory women migrant workers in Malaysia
Miles, L., Freeman, T., Lai, W., Mat-Yasin, S. and Ying, K. 2022. Empowerment as a pre-requisite to managing and influencing health in the workplace: the sexual and reproductive health needs of factory women migrant workers in Malaysia. Economic and Industrial Democracy. 43 (4), pp. 1676-1698. https://doi.org/10.1177/0143831x211024725
Sexual and reproductive health (SRH) of women migrant workers in the ASEAN region: a systematic narrative review and synthesis
Freeman, T., Miles, L., Mat-Yasin, S., Ying, K. and Lai, W. 2021. Sexual and reproductive health (SRH) of women migrant workers in the ASEAN region: a systematic narrative review and synthesis. 19th ILERA World Congress: Making and Breaking Boundaries in Work and Employment Relations. Lund, Sweden [Online] 22 - 24 Jun 2021
At the limits of "capability": The sexual and reproductive health of women migrant workers in Malaysia
Freeman, T., Miles, L., Ying, K., Mat Yasin, S. and Lai, W. 2021. At the limits of "capability": The sexual and reproductive health of women migrant workers in Malaysia. Sociology of Health & Illness. 45 (5), pp. 947-970. https://doi.org/10.1111/1467-9566.13323
Meta-regulation meets deliberation: situating the governor within NHS foundation trust hospitals
Millar, R., Freeman, T., Mannion, R. and Davies, H. 2019. Meta-regulation meets deliberation: situating the governor within NHS foundation trust hospitals. Journal of Social Policy. 48 (3), pp. 595-613. https://doi.org/10.1017/S0047279418000739
Do Hospital Boards matter for better, safer, patient care?
Mannion, R., Davies, H.T.O., Jacobs, R., Kasteridis, P., Millar, R. and Freeman, T. 2017. Do Hospital Boards matter for better, safer, patient care? Social Science & Medicine. 177, pp. 278-287. https://doi.org/10.1016/j.socscimed.2017.01.045
Decentring patient safety governance: case studies of four English Foundation Trust Hospital Boards
Freeman, T., Millar, R., Mannion, R. and Davies, H. 2017. Decentring patient safety governance: case studies of four English Foundation Trust Hospital Boards. in: Bevir, M. and Waring, J. (ed.) Decentred Health Policy: Learning from British Experiences in Healthcare Governance London, UK Routledge. pp. 70-89
Effective board governance of safe care: a (theoretically underpinned) cross-sectioned examination of the breadth and depth of relationships through national quantitative surveys and in-depth qualitative case studies
Mannion, R., Freeman, T., Millar, R. and Davies, H. 2016. Effective board governance of safe care: a (theoretically underpinned) cross-sectioned examination of the breadth and depth of relationships through national quantitative surveys and in-depth qualitative case studies. Health Services and Delivery Research. 4 (4). https://doi.org/10.3310/hsdr04040
Enacting corporate governance of healthcare safety and quality: a dramaturgy of hospital boards in England
Freeman, T., Millar, R., Mannion, R. and Davies, H. 2016. Enacting corporate governance of healthcare safety and quality: a dramaturgy of hospital boards in England. Sociology of Health & Illness. 38 (2), pp. 233-251. https://doi.org/10.1111/1467-9566.12309
An adult social care compendium of approaches and tools for organisational change
Miller, R., Freeman, T., Davidson, D. and Glasby, J. 2015. An adult social care compendium of approaches and tools for organisational change. Birmingham, UK Birmingham University.
Ethics and spirituality in the workplace: the growing role of the business case in reforms
Freeman, T., Kunter, A., Douglas, C. and Roper, I. 2015. Ethics and spirituality in the workplace: the growing role of the business case in reforms. Human Resource Management International Digest. 23 (5), pp. 43-44. https://doi.org/10.1108/HRMID-05-2015-0092
Overseeing oversight: governance of quality and safety by hospital boards in the English NHS
Mannion, R., Davies, H., Freeman, T., Millar, R., Jacobs, R. and Kasteridis, P. 2015. Overseeing oversight: governance of quality and safety by hospital boards in the English NHS. Journal of Health Services Research & Policy. 20 (1 supp), pp. 9-16. https://doi.org/10.1177/1355819614558471
Hospital board oversight of patient safety: a narrative review & synthesis of recent empirical research
Millar, R., Mannion, R., Freeman, T. and Davies, H. 2013. Hospital board oversight of patient safety: a narrative review & synthesis of recent empirical research. The Milbank Quarterly. 91 (4), pp. 738-770. https://doi.org/10.1111/1468-0009.12032
Priority setting and rationing in health care: evidence from the English NHS
Robinson, S., Williams, I., Dickinson, H. and Freeman, T. 2012. Priority setting and rationing in health care: evidence from the English NHS. Social Science & Medicine. 75 (12), pp. 2386-2393. https://doi.org/10.1016/j.socscimed.2012.09.014
Comparing the content of leadership theories and managers' shared perceptions of effective leadership: a Q-method study of trainee managers in the English NHS
Freeman, T. 2013. Comparing the content of leadership theories and managers' shared perceptions of effective leadership: a Q-method study of trainee managers in the English NHS. Health Services Management Research. 26 (2-3), pp. 43-53. https://doi.org/10.1177/0951484813513245
Priority-setting and rationing in healthcare: evidence from the English experience
Robinson, S., Williams, I., Dickinson, H., Freeman, T. and Rumbold, B. 2012. Priority-setting and rationing in healthcare: evidence from the English experience. Social Science & Medicine. 75 (12), pp. 2386-2393. https://doi.org/10.1016/j.socscimed.2012.09.014
Structures and processes for priority-setting by health-care funders: a national survey of primary care trusts in England
Robinson, S., Dickinson, H., Freeman, T., Rumbold, B. and Williams, I. 2012. Structures and processes for priority-setting by health-care funders: a national survey of primary care trusts in England. Health Services Management Research. 25 (3), pp. 113-120. https://doi.org/10.1258/hsmr.2012.012007
Resource scarcity and priority-setting: from management to leadership in the rationing of health care?
Dickinson, H., Freeman, T., Robinson, S. and Williams, I. 2011. Resource scarcity and priority-setting: from management to leadership in the rationing of health care? Public Money & Management. 31 (5), pp. 363-370. https://doi.org/10.1080/09540962.2011.598352
Disinvestment in health— the challenges facing general practitioner (GP) commissioners
Robinson, S., Dickinson, H., Freeman, T. and Williams, I. 2011. Disinvestment in health— the challenges facing general practitioner (GP) commissioners. Public Money & Management. 31 (2), pp. 145-148. https://doi.org/10.1080/09540962.2011.560714
Reflections on leadership and place
Mabey, C. and Freeman, T. 2010. Reflections on leadership and place. Policy Studies. 31 (4), pp. 505-522. https://doi.org/10.1080/01442871003723465
Performing leadership: towards a new research agenda in leadership studies?
Peck, E., Freeman, T., Six, P. and Dickinson, H. 2009. Performing leadership: towards a new research agenda in leadership studies? Leadership. 5 (1), pp. 25-40. https://doi.org/10.1177/1742715008098308
Performing governance: A partnership board dramaturgy
Freeman, T. and Peck, E. 2007. Performing governance: A partnership board dramaturgy. Public Administration. 85 (4), pp. 907-929. https://doi.org/10.1111/j.1467-9299.2007.00683.x
'Best practice' in focus group research: Making sense of different views
Freeman, T. 2006. 'Best practice' in focus group research: Making sense of different views. Journal of Advanced Nursing. 56 (5), pp. 491-497. https://doi.org/10.1111/j.1365-2648.2006.04043.x
Evaluating partnerships: A case study of integrated specialist mental health services
Freeman, T. and Peck, E. 2006. Evaluating partnerships: A case study of integrated specialist mental health services. Health and Social Care in the Community. 14 (5), pp. 408-417. https://doi.org/10.1111/j.1365-2524.2006.00658.x
Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England
Freeman, T. and Walshe, K. 2004. Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England. Quality and Safety in Health Care. 13 (5), pp. 335-343. https://doi.org/10.1136/qshc.2002.005108
Measuring progress in clinical governance: Assessing the reliability and validity of the Clinical Governance Climate Questionnaire
Freeman, T. 2003. Measuring progress in clinical governance: Assessing the reliability and validity of the Clinical Governance Climate Questionnaire. Health Services Management Research. 16 (4), pp. 234-250. https://doi.org/10.1258/095148403322488937
Using performance indicators to improve health care quality in the public sector: A review of the literature
Freeman, T. 2002. Using performance indicators to improve health care quality in the public sector: A review of the literature. Health Services Management Research. 15 (2), pp. 126-137. https://doi.org/10.1258/0951484021912897
Organisational strategies for changing clinical practice: How trusts are meeting the challenges of clinical governance
Wallace, L.M., Freeman, T., Latham, L., Walshe, K. and Spurgeon, P. 2001. Organisational strategies for changing clinical practice: How trusts are meeting the challenges of clinical governance. Quality in Health Care. 10 (2), pp. 76-82. https://doi.org/10.1136/qhc.10.2.76
The external review of quality improvement in health care organizations: A qualitative study
Walshe, K., Wallace, L., Freeman, T., Latham, L. and Spurgeon, P. 2001. The external review of quality improvement in health care organizations: A qualitative study. International Journal for Quality in Health Care. 13 (5), pp. 367-374. https://doi.org/10.1093/intqhc/13.5.367
Clinical governance. Scope to improve
Walshe, K, Freeman, T, Latham, L, Spurgeon, P and Wallace, L 2000. Clinical governance. Scope to improve. Health Service Journal. 110 (5728), pp. 30-32.