From Ward to Board

As an organisation with a track record of running nurse leadership programmes, The King's Fund was commissioned by the Burdett Trust to:

• support nurse executives and their boards by giving feedback to identify good practice and to explore, facilitate and develop models for high-quality, board-level clinical engagement
• review and interpret this work for a wider audience
• disseminate learning to a wide audience and encourage others to follow best practice.

During the first and second phases, the project team worked with nurse executives and their boards at seven and subsequently six pilot sites across the UK. The sites were chosen for the learning they could contribute about the role of the nurse executive at board level, as well as for their different approaches to managing patient care and improving the quality of the patient experience. The project team provided support for each phase of the programme through: 

• an initial site visit (to meet the nurse executive, chief executive, chair and medical director)
• three board observation visits
• three coaching sessions (telephone or face-to-face) with each nurse executive
• a small professional development grant for each nurse executive
• a half-day seminar, bringing the seven nurse executives together to share experiences
• a final discussion with the board to present the team’s findings. 

The report From Ward to Board presents the findings from the first phase of the project. It asks seven key questions:

• How does a board assure itself of the quality of clinical care?
• What is the importance of context?
• What is the right clinical information?
• What are the key relationships in the boardroom?
• What is the right balance between effective board relationships and robust governance structures?
• What difference can the nurse executive make?
• When are board members ready to hear bad news?

For each of the above there is also some thought given to implications for skills development.

The next phase, Putting quality first, also asks a number of key questions:

•  Why do boards find it difficult to engage with quality?
•  What styles of leadership has most influence on quality?
•  What type of organisational culture sustains engagement with quality?
• What systems and processes support a focus on quality?