How-to Guide: Governance Leadership (Get Boards on Board)

Institute for Healthcare Improvement
Cambridge, Massachusetts, USA​

How to cite this document:
5 Million Lives Campaign. Getting Started Kit: Governance Leadership “Boards on Board” How-to Guide. Cambridge, MA: Institute for Healthcare Improvement; 2008. (Available at

This How-to Guide recommends that boards of trustees in all hospitals undertake six key governance leadership activities to improve quality and reduce harm in their hospitals. At a minimum, boards should start by spending more than 25 percent of their meeting time on quality and safety issues and by conducting, as a full board, a conversation with at least one patient, or family member of a patient, who sustained serious harm at their institution within the last year. The guide was initially developed as part of IHI's 5 Million Lives Campaign.

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