Skip to main content

Hospital Governance

  • Reference work entry
  • First Online:
Encyclopedia of Sustainable Management
  • 5 Accesses

Synonyms

Clinical governance; Duties of hospital directors; Healthcare governance; Hospital accountability; Hospital checks and balance; Hospital directors’ responsibility; Hospital governing bodies; Structure and composition of hospital board

Definition

Hospital governance represents a term relatively complex to define. Indeed, by identifying a process-focused notion, research has recognized the existence of different levels of governance as well as of two main components (Sarto et al. 2014; Saltman et al. 2011). Specifically, literature claims the presence of three levels of hospital governance: macro, meso, and micro. The former is related with the national government decisions influencing and affecting the overall structure of a national health service in terms of financing and number/type of organizations. Differently, the meso (and intermediate) level of hospital governance is concerned with the decision-making at the hospital organizational level and identifies the governing...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 2,999.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 3,499.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aidemark, L. G., & Lindkvist, L. (2004). The vision gives wings. A study of two hospitals run as limited companies. Management Accounting Research, 15(3), 305–318.

    Google Scholar 

  • Alexander, J., & Morlock, L. (1985). Multi-institutional arrangements: Relationships between governing boards and hospital chief executive officers. Health Services Research, 19(6), 675–699.

    Google Scholar 

  • Alexander, J., Fennell, M. L., & Halpern, M. T. (1993). Leadership instability the influence hospitals: Relations of board-CEO and organizational growth and decline. Administrative Science Quarterly, 38(1), 74–99.

    Article  Google Scholar 

  • Alexander, J., Lee, S.-Y. D., Wang, V., & Margolin, F. (2009). Changes in the monitoring and oversight practices of not-for-profit hospital governing boards 1989–2005: Evidence from three national surveys. Medical Care Research and Review, 66(2), 181–196.

    Article  Google Scholar 

  • Bai, G. (2013). How do Board size and occupational background of directors influence social performance in for-profit and non-profit organizations? Evidence from California hospitals. Journal of Business Ethics, 118(1), 171–187.

    Article  Google Scholar 

  • Bai, G., & Krishnan, R. (2015). Do hospitals without physicians on the board deliver lower quality of care? American Journal of Medical Quality, 30(1), 58–65.

    Article  Google Scholar 

  • Barnett, P., Perkins, R., & Powell, M. (2001). On a hiding to nothing? Assessing the corporate governance of hospital and health services in New Zealand 1993–1998. The International Journal of Health Planning and Management, 16(2), 139–154.

    Article  Google Scholar 

  • Bodenheimer, T., & Fernandez, A. (2005). High and rising health care costs. Part 4: Can costs be controlled. Annals of Internal Medicine143(1), 26–31.

    Google Scholar 

  • Brickley, J. A., & Van Horn, R. L. (2002). Managerial incentives in nonprofit organizations: Evidence from hospitals. The Journal of Law and Economics, 45(1), 227–249.

    Article  Google Scholar 

  • Brickley, J. A., Van Horn, R. L., & Wedig, G. J. (2010). Board composition and nonprofit conduct: Evidence from hospitals. Journal of Economic Behavior and Organization, 76(2), 196–208.

    Article  Google Scholar 

  • Capasso, A., & Pascarella, G. (2011). L’azienda Sanitaria. Innovazione tecnologica, evoluzione organizzativa e governo clinico. Milano: Francoangeli.

    Google Scholar 

  • Catuogno, S., Arena, C., Saggese, S., & Sarto F. (2017). Balanced performance measurement in research hospitals: The participative case study of a haematology department. BMC Health Services Research,17(1), 522–532.

    Google Scholar 

  • Cuccurullo, C., & Lega, F. (2013). Effective strategizing practices in pluralistic settings: The case of Academic Medical Centers. Journal of Management and Governance17(3), 609–629.

    Google Scholar 

  • Daily, C. M., Dalton, D. R., & Cannella, A. A. J. (2003). Corporate governance: Decades of dialogue and data. Academy of Management Review, 28(3), 371–382.

    Article  Google Scholar 

  • Del Vecchio M. (2006), Nuove tendenze nelle strutture di governo: Interpretazioni e riflessioni a margine di un documento della Regione Emilia Romagna. In E. Anessi Pessina, & E. Cantù (Eds.), Rapporto OASI 2006. L’aziendalizzazione della sanità in Italia. Milano: EGEA.

    Google Scholar 

  • Denis, J. L., Lamothe, L., & Langley, A. (2001). The dynamics of collective leadership and strategic change in pluralistic organizations. Academy of Management Journal, 44(4), 809–837.

    Google Scholar 

  • Dorgan, S., Layton, D., Bloom, N., Homkes, R., Sadun, R., & Van Reenen, J. (2010). Management in healthcare: Why good practice really matters. London: McKinsey and and LSE (CEP).

    Google Scholar 

  • Eeckloo, K., Van Herck, G., Van Hulle, C., & Vleugels, A. (2004). From corporate governance to hospital governance. Authority, transparency and accountability of Belgian non-profit hospitals’ board and management. Health Policy, 68(1), 1–15.

    Article  Google Scholar 

  • Eeckloo, K., Delesie, L., & Vleugels, A. (2007). Where is the pilot? The changing shapes of governance in the European hospital sector. The Journal of the Royal Society for the Promotion of Health, 127(2), 78–86.

    Article  Google Scholar 

  • Erwin, C. O., Landry, A. Y., Livingston, A. C. & Dias, A. (2019) Effective governance and hospital boards revisited: reflections on 25 years of research. Medical Care Research and Review, 76(2), 131–166.

    Google Scholar 

  • Falcone, R. E., & Satiani, B. (2008). Physician as hospital chief executive officer. Vascular and Endovascular Surgery, 42(1), 88–94.

    Article  Google Scholar 

  • Fisher, E. S., Staiger, D. O., Bynum, J. P. W., & Gottlieb, D. J. (2007). Creating accountable care organizations: The extended hospital medical staff. Health Affairs, 26(1), w44–w57.

    Google Scholar 

  • Flannigan, A., & Power, P. (2008). Health care governance: Introduction. Australian Health Review, 32, 7–9.

    Article  Google Scholar 

  • Ford-Eickhoff, K., Plowman, D. A., & McDaniel, R. R. (2011). Hospital boards and hospital strategic focus: The impact of board involvement in strategic decision making. Health Care Management Review, 36(2), 145–154.

    Article  Google Scholar 

  • Glouberman, S., & Mintzberg, H. (2001). Managing the care of health and the cure of disease – Part II: Integration. Health Care Management Review, 26(1), 70–84.

    Article  Google Scholar 

  • Golden, B. R., & Zajac, E. J. (2001). When will boards influence strategy? Inclination x power = strategic change. Strategic Management Journal, 22(12), 1087–1111.

    Article  Google Scholar 

  • Goodall, A. H. (2011). Physician-leaders and hospital performance: Is there an association? Social Science and Medicine, 73(4), 535–539.

    Google Scholar 

  • Gorsky, M. (2008). Community involvement in hospital governance in Britain: Evidence from before the National Health Service. International Journal of Health Services Planning Administration Evaluation, 38(4), 751–771.

    Article  Google Scholar 

  • Grant, R. M. (1996). Toward a knowledge-based theory of the firm. Strategic Management Journal, 17(S2), 109–122.

    Google Scholar 

  • Gunderman, R., & Kanter, S. L. (2009). Perspective: Educating physicians to lead hospitals. Academic Medicine, 84(10), 1348–1351.

    Google Scholar 

  • Ham, C., & Dickinson, H. (2008). Engaging doctors in leadership: What we can learn from international experience and research evidence? Coventry: NHS Institute for Innovation and Improvement, Academy of Medical Royal Colleges and Health Services Management Centre, University of Birmingham.

    Google Scholar 

  • Hamilton, D. (2008). The challenge of sustainable hospital building. Frontiers of Health Services Management, 25(1), 33–36.

    Article  Google Scholar 

  • Hood, C. (1991). A public management for all seasons? Public Administration, 69(1), 3–19.

    Article  Google Scholar 

  • Huse, M. (2007). Boards, governance and value creation. The human side of corporate governance. New York: Cambridge University Press.

    Google Scholar 

  • Jarzabkowski, P., & Fenton, E. (2006). Strategizing and organizing in pluralistic contexts. Long Range Planning, 39(6), 631–648.

    Google Scholar 

  • Jiang, H. J., Lockee, C., Bass, K., & Fraser, I. (2009). Board oversight of quality: Any differences in process of care and mortality? Journal of Healthcare Management, 54(1), 15–30.

    Article  Google Scholar 

  • Judge, W., & Zeithaml, C. (1992). An empirical comparison between the board’s strategic role in nonprofit hospitals and in for-profit industrial firms. Health Services Research, 27(1), 47–64.

    Google Scholar 

  • Kane, N. M., Clark, J. R., & Rivenson, H. L. (2009). The internal processes and behavioral dynamics of hospital boards: An exploration of differences between high-and low-performing hospitals. Health Care Management Review, 34(1), 80–91.

    Google Scholar 

  • Kirkpatrick, I., Bullinger, B., Lega, F., & Dent, M. (2013). The translation of hospital management models in European health systems: A framework for comparison. British Journal of Management, 24, S48–S61.

    Article  Google Scholar 

  • Kirkpatrick, I., Hartley, K., Kuhlmann, E., & Veronesi, G. (2014). Clinical management and professionalism. In E. Kuhlmann (Ed.), The Palgrave international handbook of healthcare policy and governance. London: Palgrave Macmillan.

    Google Scholar 

  • Kuntz, L., & Scholtes, S. (2013). Physicians in leadership: The association between medical director involvement and staff-to-patient ratios. Health Care Management Science, 16(2), 129–138.

    Google Scholar 

  • Lister, E. D. (2000). From advocacy to ambassadorship: Physician participation in healthcare governance. Journal of Healthcare Management, 45(2), 108–118.

    Article  Google Scholar 

  • Lister, E. D. (2007). Physicians in the boardroom. Healthcare Executive, 22(4), 58–61.

    Google Scholar 

  • Martin, G. P. (2011). The third sector, user involvement and public service reform: A case study in the co-governance of health service provision. Public Administration, 89(3), 909–932.

    Google Scholar 

  • Mintzberg, H. (1979). The structuring of organizations. Englewood Cliffs: Prentice Hall.

    Google Scholar 

  • Molinari, C., Morlock, L., Alexander, J., & Lyles, C. A. (1993). Hospital board effectiveness: Relationships between governing board composition and hospital financial viability. Health Services Research, 28(3), 358–377.

    Google Scholar 

  • Molinari, C., Alexander, J., Morlock, L., & Lyles, C. A. (1995). Does the hospital board need a doctor? The influence of physician board participation on hospital financial performance. Medical Care, 33(2), 170–185.

    Article  Google Scholar 

  • Molinari, C., Hendryx, M., & Goodstein, J. (1997). The effects of CEO-board relations on hospital performance. Health Care Management Review, 22(3), 7–15.

    Google Scholar 

  • Morlock, L., Alexander, J., & Hunter, H. M. (1985). Formal relationships among governing boards, CEOs, and medical staffs in independent and system hospitals. Medical Care, 23(10), 1193–1213.

    Article  Google Scholar 

  • Nunes, R., Rego, G., & Brandão, C. (2007). The rise of independent regulation in health care. Health Care Analysis, 15(3), 169–177.

    Article  Google Scholar 

  • Powers, T. L., & Bendall, D. (2004). Improving health outcomes through patient empowerment. Journal of Hospital Marketing and Public Relations, 15(1), 45–59.

    Google Scholar 

  • Preker, A. S., & Harding, A. L. (2003). Innovations in health service delivery: The corporatization of public hospitals. Washington: World Bank.

    Book  Google Scholar 

  • Prybil, L. D., Levey, S., Killian, R., Fardo, D., Chait, R., Bardach, D., & Roach, W. (2012). Governance in large nonprofit health systems. Current profile and emerging patterns. Lexington: Commonwealth Center for Governance Studies.

    Google Scholar 

  • Ramsay, A., & Fulop, N. (2010). The healthy NHS board a review of guidance and research evidence. London: National Leadership Council.

    Google Scholar 

  • Saltman, R., Durán, A., & Dubois, H. (2011). Governing public hospitals. Reform strategies and the movement towards institutional autonomy. Copenhagen: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Sarto, F. (2015). La governance delle aziende ospedaliere. Il ruolo del medico-manager. Padova: CEDAM.

    Google Scholar 

  • Sarto, F., & Veronesi, G. (2016). Clinical leadership and hospital performance: Assessing the evidence base. BMC Health Services Research, 16(2), 85–97.

    Google Scholar 

  • Sarto, F., Cuccurullo, C., & Aria, M. (2014). Exploring healthcare governance literature: Systematic review and paths for future research. Mecosan, 91, 61–80.

    Google Scholar 

  • Sarto, F., Veronesi, G., Kirkpatrick, I., Cuccurullo, C. (2016). Exploring regionalism in public management reforms: The case of the Italian hospital sector. Policy and Politics, 44(4), 525–545.

    Google Scholar 

  • Sarto, F., Saggese, S., & Catuogno, S. (2017). Peculiarità degli ospedali pubblici e riflessi sul governo aziendale: verso una governance partecipativa. Azienda Pubblica, 1, 33–50.

    Google Scholar 

  • Sarto, F., Veronesi, G., & Kirkpatrick, I. (2019). Organizing professionals and their impact on performance: The case of public health doctors in the Italian SSN. Public Management Review, 21(7), 1029–1051.

    Article  Google Scholar 

  • Stolzenberg, E. A. (2000). Governance change for public hospitals. Journal of Healthcare Management, 45(5), 347–350.

    Article  Google Scholar 

  • Succi, M. J., & Alexander, J. (1999). Physician involvement in management and governance: The moderating effects of staff structure and composition. Health Care Management Review, 24(1), 33–44.

    Article  Google Scholar 

  • The King’s Fund. (2011). The future of leadership and management in the NHS. No more heroes. London: The Kings Fund.

    Google Scholar 

  • The King’s Fund. (2012). Leadership and engagement for improvement in the NHS: Together we can. London: The King’s Fund.

    Google Scholar 

  • Veronesi, G., & Keasey, K. (2015). Patient and public participation in the English NHS: An assessment of experimental implementation processes. Public Management Review, 17(4), 543–564.

    Article  Google Scholar 

  • Veronesi, G., Kirkpatrick, I., & Vallascas, F. (2013). Clinicians on the board: What difference does it make? Social Science and Medicine, 77, 147–155.

    Article  Google Scholar 

  • Veronesi, G., Kirkpatrick, I., & Vallascas, F. (2014). Does clinical management improve efficiency? Evidence from the English National Health Service. Public Money and Management, 34(1), 35–41.

    Article  Google Scholar 

  • Vining A. R., & Weimer D. (2005). Economic perspective on public organizations. In E. Ferlie, L. E. Lynn, & C. Pollitt (Eds.), The oxford handbook of public management. Oxford: Oxford University Press.

    Google Scholar 

  • Von Nordenflycht, A. (2010). What is a professional service firm? Toward a theory and taxonomy of knowledge-intensive firms. Academy of Management Review, 35(1), 155–174.

    Google Scholar 

  • Weil, T. P. (2003). Governance in a period of strategic change in U.S. healthcare. The International Journal of Health Planning and Management, 18(3), 247–265.

    Article  Google Scholar 

  • Winch, G., & Schneider, E. (1993). Managing the knowledge-based organization: The case of architectural practice. Journal of Management Studies, 30(6), 923–937.

    Google Scholar 

  • Witman, Y., Smid, G. A. C., Meurs, P. L., & Willems, D. L. (2010). Doctor in the lead: Balancing between two worlds. Organization, 18(4), 477–495.

    Article  Google Scholar 

  • Young, G. J., Beekun, R. I., & Ginn, G. O. (1992). Governing board structure, business strategy, and performance of acute care hospitals: A contingency perspective. Health Services Research, 27(4), 543–564.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fabrizia Sarto .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Sarto, F. (2023). Hospital Governance. In: Idowu, S.O., Schmidpeter, R., Capaldi, N., Zu, L., Del Baldo, M., Abreu, R. (eds) Encyclopedia of Sustainable Management. Springer, Cham. https://doi.org/10.1007/978-3-031-25984-5_882

Download citation

Publish with us

Policies and ethics