August 27, 2015

It seems that more and more hospitals are seeing the benefits of having patient care representation as voting members of the Board of Trustees. This perspective offers key insight from both an organization and a clinical standpoint that is necessary for hospitals aiming to effectively reduce patient harm and unnecessary readmissions.  Nurses, in close collaboration with other health care professionals who are on the frontlines of direct care, are deeply woven into the day to day tasks that keep hospitals and health care systems running smoothly, and they have a holistic understanding of the patient experience. The value of this expertise is growing as the focus of the Board shifts to assume accountability for the quality and safety of the care delivered in its health care system.

Among the increasing number of nurses finding their seats at the board table are two of the College of Nursing and Health Professions’ own: Faye Meloy, PhD, Associate Dean of Pre-licensure Nursing Programs, and Al Rundio, PhD, Associate Dean of Post-Licensure Nursing Programs. Meloy and Rundio are bringing a global perspective, encompassing years of clinical, educational and administrative experience, to Virtua Health System and Inspira Health Network, respectively. Bringing their credentials as academics who have both previously served as Chief Nursing Officers, Meloy and Rundio are well-qualified leaders with a keen understanding of the delicate balance between business and patient care services. 

Both Virtua and Inspira are comprehensive health care systems. Virtua consists of three health and wellness centers, three fitness centers, three acute care hospitals, primary and specialty physician practices with more than 240 physicians, urgent care centers, seven ambulatory surgery centers, home health services, two long-term care and rehabilitation centers, 12 paramedic units and a wide range of outpatient services. Inspira Health Network entails of three hospitals, four multi-specialty health centers and a total of more than 60 locations. These include outpatient imaging and rehabilitation centers; numerous specialty centers, including sleep medicine, cardiac testing and wound care; and more than two dozen primary and specialty physician practices. With services this far-reaching, patient experience and quality of care remain a priority and it truly takes a Board with well-rounded representation to deliver.

During an initial meeting with Inspira’s board chair, Rundio recalled that he “loved the connection to the academic setting, and the fact that I could bring a Philadelphia connection to rural America. He felt my insight would offer a nice outlook on the Board.” Meloy added, “We (in academia) are the voice of their supplier. We supply all of their clinicians -- nurses, administrators, physical therapists or nutritionists to name a few. There’s a wonderful give and take. We can hear what their needs are and come back and brainstorm how we can meet them. And they get input from the people who are providing the staff as well as the cutting-edge in research and evidence-based practice they need.”

So how are they contributing? Meloy said her voice is welcomed by board members, and she is working to bring to the forefront the achievements of the unsung heroes of the health systems, those who create the patient experience. “I am able to raise important questions when others are presenting to the Board that they have either not considered or need to hear the answer to.” Meloy cited a recent instance in which she highlighted an impressive patient care accomplishment, in which there were no reported occurrences of skin breakdown (bed sores). From a clinical standpoint, Meloy understands the magnitude of that statistic as well as the effort of staff that brought it to fruition. “It is almost unheard of in acute care facilities to have not only a low rate, but a no incident rate of bed sores considering the debilitated population they are frequently seeing,” she said. “I felt that it was important for the Board to know. I also wanted to make sure they understood that they put a lot of fiscal resources into equipment and training, and those resources were very important in this instance.”

Rundio, though new to the Inspira Board, said this opportunity is one of his bucket list items. As a CNO, he attended all Board meetings, and could influence with his opinions regarding nursing issues, but he was unable to vote. “My vision was that it would be great if I could serve on a hospital Board as a nurse because they all have physician representation and I think this perspective is just as critical,” said Rundio. “I want to give back to the profession. We are representing that clinical piece, which is often missing from boardroom discussion.”

With the number of patient care staff not only in hospitals, but in long-term care, home care and outpatient care, on the rise, there is a shift in hospital leadership becoming increasingly aware of the value-add that this insight and understanding can bring. According to a recent issue of Trustee Magazine, nursing groups and organizations are taking steps to fill the gap through the identification of prospective nurse trustees and the development of leadership training programs. 
In her 18 months serving the Board at Virtua, Meloy is seeing a change in the landscape of health care leadership across the country first hand. “I am proud to be part of an organization that has made a genuine commitment to the highest level of quality throughout the spectrum of services provided and that recognizes both the importance of diversity in Trustee representation and the valuable perspectives/experiences a nursing leader brings to the Board Room.” However, she is also quick to add that the position also entails a great deal of responsibility, commitment and humility.   “It’s not about breaking through the ‘glass ceiling’ but rather, another step in her professional journey of “making a difference.”