The quagmire of hospital governance. Finding mission in a revised licensure model.

摘要

Governance lies at the core of the American hospital and, together with the medical staff and administration, is one of three foundational elements of structure that is universal to all types of acute care institutions.1 The evolution of the hospital board is tightly linked to the development, growth, and ongoing changes in medicine that frame the acute care institution over time, and is a matter of continuing interest to parties in health care delivery, management, and regulation. Although various structural models of governance populate the hospital landscape, there are considerable commonalities in overall goals and functions of boards that make generic evaluation of governance feasible. Examination of the commonalities in board structures and functions underscores a high level of ambiguity in how this critical function of institutional operations ought to be cast.