Objective: Identify the extent to which hospital boards of trustees, CEOs, and CNOs are engaged in quality and safety at the leadership and governance level and how CNOs can support board engagement in quality and safety.
Background: Although research is emerging, still relatively little is known about the impact and interface of hospital boards of trustees, CEOs, and nursing executives related to improving quality and patient safety.
Methods: 73 telephone interviews were conducted with hospital board chairs, CEOs, and CNOs from a convenience sample of 63 U.S. hospitals. The interviews (22 of which were with CNOs) lasted 30 to 45 minutes and were supplemented by a focus group of five nursing executives.
Results: There are significant differences in the perceptions of CNOs versus those of board chairs and CEOs. CNOs reported a greater familiarity of landmark reports on quality and patient safety than board chairs. CEOs and board chairs gave substantially higher ratings to integration of quality planning. Boards have limited comprehension of salient nursing quality issues.
Conclusion: CNOs have a critical role as boardroom champions of patient safety and quality improvement.