Case Study: Getting Boards on Board at Allen Memorial Hospital, Iowa Health System

Background: In 2005, the board of Allen Memorial Hospital, located in Waterloo, Iowa, in association with the leadership and medical staff, committed itself to the Institute of Health Care Improvement's 5 Million Lives Campaign interventions-Six Things All Boards Should Do to Improve Quality and Reduce Harm. Interventions: (1) Setting an Aim; (2) Getting Data and Hearing Stories; (3) Establishing and Monitoring System-Level Measures; (4) Changing the Environment, Policies, and Culture; (5) Learning. Starting with the Board; and (6) Establishing Executive Accountability. For example, for intervention 3, the Allen board approved 10 clinical, evidence-based standards of care and 27 measures for monthly administrative and quarterly board review. A scorecard of these measures was developed to be presented as a handout at the meetings and to be displayed in poster size in each unit on a monthly basis. To make strides on these measures, rapid improvement teams were implemented, led by both a physician champion and a frontline clinical champion. Improvement in Focus and Outcomes: Allen's rapid improvement teams have generated measurable success in quality and patient safety. The drive to excellence in clinical care was beginning to be "hard wired" into standard processes, monitoring systems, and periodic reviews. Processes were established to review every process failure and concern of the involved staff.