Objectives: Identify characteristics of hospital leadership engagement in quality improvement that are most likely to strengthen quality improvement activities within hospitals.
Methods: The University of Iowa coordinated the administration of a hospital quality improvement (QI) and leadership short survey to chief executive officers and senior quality executives from a sample of hospitals in 8 states.
Results: Better quality index scores are associated with hospitals where the board (1) spends more than 25% of their time on quality issues, (2) receives a formal quality performance measurement report, (3) bases the senior executives' compensation in part on QI performance, and (4) engages in a high level of interaction with the medical staff on quality strategy. Better quality index scores are also associated with the chief executive officer being identified as the person with the greatest impact on QI, especially when identified as such by the QI executives.
Conclusions: The results of the survey show that hospital leadership is engaged in quality, but in a manner that can be enhanced. Several changes in leadership structures and systems relating to boards and senior administrative management teams are recommended so that the QI that is desired by all Americans can be realized in the hospital industry.