Governance education for nurses: Preparing nurses for the future.

The complexities of today's health care environment require organizational governing boards to have deeper understanding of health needs, influences, and outcomes with diverse board leadership. Nurses understand the complexities and demands of health care, but few nurses are engaged on boards of directors and many nurses feel unprepared for the governance leadership role. The nurse of the future requires governance knowledge and competencies to influence organizational policies that will improve health care outcomes and advance health promotion. Governance education is a necessary component of preparing the nurse of the future to influence health care transformation. Until nurses can confidently embrace governance leadership as a part of their professional identity, convincing and expecting non-nurse board leaders to appoint nurses to boards will continue to be a challenge. This paper describes a strategy for incorporating governance competencies into nursing curricula across all education levels by leveraging the American Hospital Association Governance Core Competencies (2009) and the Massachusetts Nurse of the Future Core Competencies©-RN (Massachusetts Department of Higher Education Nursing Initiative, 2016).

Employing the Precautionary Principle to Evaluate the Use of E-Cigarettes.

Electronic cigarettes (e-cigarettes) have emerged onto the public market as an alternative to tobacco cigarettes; however, science is inconclusive as e-cigarettes have not been thoroughly investigated, including their short- and long-term risks and benefits (1, 2). The question arises of whether e-cigarettes will become the future tobacco crisis. This paper connects the precautionary principle to the use of e-cigarettes in an effort to guide decision-makers in the prevention of adverse health outcomes and societal costs.

Board oversight of patient care quality in large nonprofit health systems.

In hospitals and health systems, ensuring that organizational standards for patient care quality are adopted and that processes for monitoring and improving clinical services are in place are among governing boards' most important duties. A recent study examined board oversight of patient care quality in 14 of the country's 15 largest private nonprofit health systems. The findings show that 13 of the 14 boards have standing committees with oversight responsibility for patient quality and safety within their system; 11 of the 14 system boards formally adopt systemwide quality measures and standards; and all 14 regularly receive written reports on systemwide and hospital performance. In recent months, most of these boards had adopted action plans directed at improving their system's performance with respect to patient care quality.

Board oversight of community benefit: an ethical imperative.

Board oversight of community benefit responsibility in tax-exempt organizations in the nonprofit health care sector is attracting considerable attention. Scrutiny by the IRS and other official bodies has led to stricter measures of compliance with the community benefit standard. But stricter compliance does not sufficiently engage the underlying ethical imperative for boards to provide effective oversight--an imperative that recent research suggests has not been sufficiently honored. This analysis considers why there is a distinctively ethical imperative for board oversight, the organizational nature of the imperative involved, and practical ways to fulfill its obligations. We adopt an organizational ethics paradigm to illuminate the constituent components of the ethical imperative and to clarify emerging benchmarks as flexible guidelines. As these emerging benchmarks enhance board oversight of community benefit they also can shed light on what it means to be a virtuous organization.

Board oversight of patient care quality in community health systems.

In hospitals and health systems, ensuring that standards for the quality of patient care are established and continuous improvement processes are in place are among the board's most fundamental responsibilities. A recent survey has examined governance oversight of patient care quality at 123 nonprofit community health systems and compared their practices with current benchmarks of good governance. The findings show that 88% of the boards have established standing committees on patient quality and safety, nearly all chief executive officers' performance expectations now include targets related to patient quality and safety, and 96% of the boards regularly receive formal written reports regarding their organizations' performance in relation to quality measures and standards. However, there continue to be gaps between present reality and current benchmarks of good governance in several areas. These gaps are somewhat greater for independent systems than for those affiliated with a larger parent organization.

Size, composition, and culture of high-performing hospital boards.

At the national, state, and community levels of American society, there is a growing cry for more accountability and better performance by the governing boards of business firms, institutions of higher learning, and health care organizations. A recently completed study has examined selected aspects of governance in a set of high-performing nonprofit hospitals versus hospitals that are similar in several respects but whose performance is midrange. This article discusses the findings with respect to the boards' size, composition, and culture.

Characteristics of effective boards.

High-performing boards in all business sectors share many common traits: ongoing development; efficient, prioritized agendas; and solid structure and processes. Most important of all, however, is strong support from the top.

Transforming the accreditation of health care management education.

Recognizing the considerable changes occurring over recent years in health care, the Accrediting Commission on Education for Health Services Administration (ACEHSA) sought to remake itself to become a more vital participant in the field. This article reports the rationale, objectives, and process pursued by ACEHSA as it underwent this transformation and adopted a new name: Commission on Accreditation of Healthcare Management Education (CAHME). This paper features the planning document adopted to lead CAHME through the future. It also highlights actions taken to date and subsequent steps planned.

Developing the academic institution's role in response to bioterrorism: the Iowa Center for Public Health Preparedness.

The terrorist acts during the fall of 2001 triggered renewed concern about the capacity of the nation's public health system to deal with crisis. A critical element of the response ability of the public health system is a prepared workforce. Based on a pre-existing concern about emerging infectious disease, the Centers for Disease Control (CDC), working with the Association of Schools of Public Health, had established a network of university-based Centers for Public Health Preparedness. The events of September 11 accelerated, expanded, and focused this effort. This article discusses this national program, details the activities of the based Center for Public Health Preparedness located at the University of Iowa, and suggests preparedness issues deserving future development.