Hospitals Must Recruit Nurses to Their Leadership Boards

Oct 9, 2014, 11:00 AM, Posted by David L. Knowlton

Nurses truly run the front lines of hospitals. Their leadership oversees every hospital quality initiative essential to improving care—from reducing hospital-acquired infections, to cutting unnecessary readmissions, to preventing patient falls.

Poor scores in these quality measures now result in government penalties that can hit hospitals hard.

And as health care evolves and hospitals stretch beyond their own walls, nurses are leading the programs that bring health care into communities. They are critical to the success of health reform as more Americans obtain health insurance and seek primary care.

So tell me something? Why is the highest level of hospital leadership in our nation nearly devoid of nurses?

Surveys find the number of nurses with voting positions on hospital boards is about 4 to 6 percent — an unfathomable statistic for anyone who understands, even a little, how hospitals work.

We need the leadership of nurses on every hospital board.

As Chairman of the Board of St. Francis Medical Center in Trenton, one of my first actions was to recruit a nurse as a full member of the board. Nurses bring a patient-centric view of health care and a clinical background critical to the far-reaching and complex issues the board must address.

I mean no disrespect to the attorneys, business leaders and other committed people on hospital boards when I say the perspective of nurses is invaluable. Nurses understand the day-to-day workings of a hospital better than any other profession—yes, even doctors.

I must say that I am mystified at the lack of nurses on boards. Why the waste of talent? I hear the argument that putting nurses on boards can be a conflict because they might put the needs of fellow nurses above the overall needs of the hospital.

Every nurse I have ever met put the needs of patients first. Regardless, a board must seek and can easily find a nurse who is not a hospital employee—perhaps a nursing professor or advanced practice nurse with a private practice. The ethical requirements for any board member would apply to any nurse on the board.

We know the push for quality is stronger than ever. Any hospital that wants to avoid the Medicare penalties or—just as harmful—the bad publicity that can follow low quality ratings needs a nurse on its board. When I became chair of The Leapfrog Group, a non-profit organization promoting safety, quality and affordability of health care, I recruited a nurse to the board. It seemed foolish to even talk about safety and quality without a nurse at the table.

And today hospital patient satisfaction surveys are public. No medical profession is more closely connected to patient satisfaction than the nursing profession. If you have ever been in a hospital—and I have—you know that nurses are the folks most responsible for all of your day-to-day care.

I believe the leaders in hospitals recognize the value of nurses. They know nurses are essential to everyday patient care. But I suspect too many hospital board members fail to see nurses as leaders. The nursing role has changed as nurses today run private practices, obtain advanced degrees and prescribing privileges, and run many hospitals as CEOs.

The role of nurses has changed faster than the perception of nurses held by too many people on hospital boards. That needs to change, not for the sake of nurses but for the sake of hospitals and all of us as patients.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.