The Role of Governance in Healthcare Organizations
Governance is a framework that accounts for all the processes of governing organizations and businesses. It’s a structure that holds boards and leaders accountable for continuously improving operations, clinical staff and processes, society and financial performance. A healthcare board of directors and executive management are in charge of all aspects of corporate governance. Another aspect of governance is the clinical side of things, which includes caring for patients, managing clinical practices and administration. The role of governance in healthcare organizations looks a bit different than it does in other types of industries.
The board and the executives have many things to juggle on both sides of governance. Both sides establish goals and objectives to strive for and they need to manage risks as well. The expanse and complexities of healthcare governance are strong motivators for healthcare organizations to invest in board management software to ensure that they’re fulfilling all aspects of governance and keeping all matters confidential.
Understanding Governance in the Healthcare Realm
Maintaining and improving the quality and safety of patient care falls under clinical governance.
Business performance, compliance with laws and regulations, as well as ethics falls under corporate governance. Corporate governance is necessary because healthcare organizations are accountable to their stakeholders and to the surrounding community.
There is a strong interconnection between corporate and clinical governance because the revenue cycles and reimbursement policies fall under corporate governance and they directly affect reimbursement monitoring and risk management activities in clinical governance.
With no model to follow, healthcare organizations are attempting to define their own governance models to help achieve their corporate and clinical objectives. Governance in healthcare organizations continues to evolve as they navigate their way to implementing an integrated governance system that transcends clinical governance and corporate governance effectively.
The leaders in healthcare organizations have identified certain things that lead to general problems with healthcare governance. First, healthcare boards have to deal with problems caused by weak or underperforming clinical or corporate governance. Second, while leaders and staff recognize the importance and the differences between clinical and corporate governance, they don’t understand how the two systems are linked. As a result, there is a lack of communication and respect between the systems inside the organization.
In addition, the boundaries between corporate and clinical governance are blurred or nonexistent, which contributes to the problem. Additional problems result when physician leaders delegate their governance responsibilities to administration and lower-level leaders.
Corporate governance encompasses many matters that aren’t players at all in clinical governance. Matters such as accounting, finance, investment, human resources, IT, facilities and security all fall under corporate governance. Yet, these matters support patient care, practice processes, healthcare procedures and other structures that healthcare organizations need to serve patients and to meet compliance obligations.
Clinical and Corporate Governance: Separate and Linked
Clinical and corporate governance systems are intrinsically linked, although each has its own objectives. For example, clinical governance requires staff to deliver measurable and effective patient care that is also consistent and safe. Clinical goals must incorporate structures that help them continually assess and monitor clinical risks to achieve the best possible outcomes.
Corporate and clinical governance must work in concert to ensure that healthcare organizations achieve their business goals, ensure quality of services and manage resources well. Healthcare organizations are expected to operate as ethical citizens would. Risk management is another area in which clinical and corporate governance are intrinsically linked.
Clinical and Corporate Governance Incorporate Risk Management
One major risk management issue pertains to how clinical systems transfer electronic medical records (EMR) and whether current processes respect patient confidentiality and HIPAA rules, which could lead to malpractice lawsuits and payer recovery audits. In addition, improper practices for transferring sensitive healthcare information could negatively affect patient care.
Both governance systems can better assess potential reimbursement and clinical risks through billing and compliance monitoring activities. Reimbursement specialists are responsible for reporting risks to the appropriate parties for investigation. As corporate governance activities focus on regulatory and compliance risks, clinical governance activities focus on patient safety and EMR risks and use technology to unite the information. The reimbursement department plays a key governance role in healthcare organizations in the risk management process because it streamlines potential issues and transfers them to the appropriate management level. For this solution to be successful, it’s necessary for compliance and reimbursement staff to clearly understand their organization’s governance structure and be willing to voice issues and document risks through the proper channels.
It’s crucial for healthcare organizations to put training programs in place across systems so that all employees know and understand their unique role of governance in healthcare organizations and risk management, especially during times of transition.
Another crucial component of risk management in healthcare is to establish feedback loops among stakeholders to set the stage for continual improvement on how corporate and clinical governance systems interface with each other toward the goal of the highest-quality outcomes for patients.
Board Management Software Supports Clinical and Corporate Governance
Clinical and corporate governance systems are facing the most drastic changes they’ve seen since they came into existence. Now, more than ever, they need technology to unite clinical and corporate governance systems by bringing the right stakeholders together, establishing a shared understanding of each other’s objectives, aligning incentives and the rules of engagement, and carefully prioritizing activities.
A board management software program by BoardEffect brings all the appropriate parties under one electronic platform that uses state-of-the-art security to protect their collaborative efforts. By using BoardEffect’s programs, board directors, executives and others allow those involved with corporate and clinical governance to work separately and together. They can also bring in risk management teams as necessary. The software includes a feature where administrators can set granular permissions so that only those who need to access various parts of the system, and who are authorized to do so, can have access.
BoardEffect is an industry leader in board management software programs for healthcare organizations. As change continues to develop rapidly, BoardEffect designed its system to assist healthcare boards manage the issues of today, as well as for the future, and all the transitions in between.
