At BIDMC, we have a "bicameral" form of governance. Our 20-member Board of Directors has formal fiduciary responsibility for the hospital. They are aided by a 50-member Board of Trustees who run the various board committees (from finance to patient care to community benefits and so on.) The trustees meet quarterly as a group, too, to receive updates on hospital matters and to hear a presentation on some topic of general interest. In addition we also have a larger community advisory group, called the Board of Overseers, many of whose members choose to serve on board committees, too.Today, a joint meeting of the Trustees and Overseers offered something new, a discussion on medical ethics led by Dr. Lachlan Forrow, Director of our Ethics Support Services. After Lachlan gave an ethics overview and introduction of our program, the Trustees and Overseers were given actual case studies to discuss and debate, much the way our staff does in our regular ethics conferences. Members of the ethics staff facilitated conversations at each table, and then Lachlan offered a summation.
Trustees and Overseers expressed great appreciation for the event, in that it provided an insight into the difficulties faced by caregivers when ethical issues arise during medical treatment. They also understood that they have an important role in setting the ethical standards for our hospital.
I know this is a bit off-topic, but good grief, that's a lot of oversight to coordinate! If the Trustees run all the committees (such as the Quality Assurance Committee or equivalent), then how do they coordinate and communicate information regarding that all-important activity to the Directors, who are formally responsible to accrediting agencies for the hospital's quality activities?
ReplyDeleteIt just seems a bit cumbersome, unless I am missing something.
nonlocal
Think of our Board of Directors as the Executive Committee of a traditional hospital board of trustees. Both have committees reporting to them. That's the best parallel.
ReplyDeleteThanks, but - wow.
ReplyDeleteIf I may ask, to which one would the MRSA outbreak have been reported - in view of Dr. Sand's letter stating the DPH "had
concerns about our system for reporting infection clusters to leadership bodies within the hospital". (Or was this concern regarding reporting at a lower level, such as individual department to senior executives).
Just curious, thanks.
nonlocal
The concern was mainly about timely reporting to senior management and to the Board's Patient Care Assessment Committee. There had been proper reporting to regulatory agencies.
ReplyDelete