Governance Practices and Performance in US Academic Medical Centers

Marilyn Szekendi, Lawrence Prybil, Daniel L. Cohen, Beth Godsey, David W. Fardo, Julie Cerese

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Recognition of the complex nature of modern health care delivery has led to interest in investigating the ways in which various factors, including governance structures and practices, influence health care quality. In this study, the chief executive officers (CEOs) of US academic medical centers were surveyed to elicit their perceptions of board structures, activities, and attitudes reflecting 6 widely identified governance best practices; the relationship between use of these practices and organizational performance, based on the University HealthSystem Consortium’s Quality & Accountability rankings, was assessed. High-performing hospitals showed greater use of all 6 practices, but the strongest evidence supported a focus on board member education and development, the rigorous use of performance measures to guide quality improvement, and systematic board self-assessment processes. All hospitals, even those with the highest quality ratings, had major gaps in their use of best practices for CEO and board assessments. These findings can serve as the basis for developing sound board improvement plans.

Original languageEnglish
Pages (from-to)520-525
Number of pages6
JournalAmerican Journal of Medical Quality
Issue number6
StatePublished - Nov 1 2015

Bibliographical note

Publisher Copyright:
© 2014, © The Author(s) 2014.


  • governance best practices
  • health care governance
  • patient safety
  • quality performance

ASJC Scopus subject areas

  • General Medicine


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