Hospital boards oversee a number of programs to ensure that their hospitals honor their missions and core values while remaining profitable. The policies they create and the decisions they make affect both clinical and non-clinical employees. The IOM report, The Future of Nursing: Leading Change, Advancing Health, shows that there is an underrepresentation of nurses in leadership roles and recommends that hospitals include nurse leaders on their boards. Nurses on these boards have usually completed a Master of Science in Nursing Administration (MSN) program, where they acquired the knowledge and skills necessary to provide leadership in nursing on a hospital board.
For decades, healthcare executives like chief executive officers (CEOs) and chief financial officers (CFOs) — as well as physicians — have comprised these boards. Since the board’s primary responsibilities were financial concerns, clinical expertise was not important. However, two key changes have altered this model.
A Time for Change
As more insurance companies shift from fee-for-service to value-based reimbursements, quality metrics are increasingly important to maintaining revenue. Value-based reimbursements depend on the quality, and not the quantity, of patient care. As a result, boards are becoming more involved in quality improvements and benchmarking. Because of the changes to the reimbursement model, nurses’ insights regarding quality metrics are now much more desirable.
Growing patient diversity is also creating a need for nurses on hospital boards. By 2043, the nation will become a majority-minority population where no racial or ethnic group holds the majority. Hispanic and Asian populations should double by 2060, and minority groups overall will comprise 57 percent of the U.S. population.
As patient populations have diversified, so have nurses. However, representation on hospital boards has not kept pace. In 2011, 90 percent of hospital board members were Caucasian. By 2014, those numbers were only slightly better at 88 percent. The same disparity afflicts gender representation. Since 2005, male board members have outnumbered female members approximately three to one.
The Need for Nurses
Due to these factors, hospital boards have begun including nurses for their clinical insight. After completing a MSN program, nurse managers often have the backgrounds and expertise necessary to influence good policymaking.
While physicians may be able to offer the board a particular clinical perspective, nurses can provide the patient experience. Nurses know where gaps in great patient care exist. They can quickly identify inconsistencies in quality of care and how to improve them. Since value-based reimbursements are becoming more common, boards have a vested interest in learning how to help nurses and clinical staff increase quality measures.
Nurses are also skilled communicators. They are used to assuming leadership in nursing roles by serving as the primary liaisons between physicians, family members and patients. They can use these same skills to express the concerns of their fellow nurses to board members in a diplomatic manner and, later, ease their coworkers’ transitions into new policies.
Nurses are often the first and last people that patients and family members see during their hospital visits. Because nurses typically spend more time with patients than other providers, they learn more about patient needs, expectations, likes and dislikes — all of which is powerful information that can inform strategic community initiatives.
The Evolution of Boards
Just like everything else in healthcare, hospital boards are evolving. Nurses who are open to leadership roles may find that boards welcome their insights and suggestions, particularly as they relate to clinical quality improvements and meeting the needs of a more diverse patient population. Nurses who participate on hospital boards have the rare opportunity to influence the decision-making processes and policies that will affect their nursing careers.
Learn more about the UTA online MSN in Nursing Administration program.
The Future of Nursing: Leading Change, Advancing Health. (2010, October 5) The National Academies of Sciences: Health and Medicine Division
2014 National Health Care Governance Survey. (2014). Center for Healthcare Governance
Enhancing Diversity in the Workforce. (2015, March 15). American Association of Colleges of Nursing
U.S. Census Bureau Projections Show a Slower Growing, Older, More Diverse Nation a Half Century from Now. (2012, December 12). United States Census Bureau
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