Challenges in Evaluating Clinical Governance Systems in Iran: A Qualitative Study

Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Ebrahimipour, Hossein

doi:10.5812/ircmj.13421

Cited by 13 publications

(17 citation statements)

References 38 publications

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“…In fact, the findings suggested the personalization and instability of evaluation method, while valid evaluation can be an incentive to improving the performance of hospitals and identifying weaknesses to resolve them. This finding is in line with the results of Hooshmand et al, in which the differences observed in evaluation methods were attributed to the difference in techniques and methods of evaluation, personal and interpersonal differences, lack of a guide for evaluation, and the similarity between evaluation and clinical audit . Similarly, Halligan et al stated that clinical governance requires precise evaluation and control in order to be successful.…”

Section: Discussionsupporting

confidence: 88%

Administrative challenges of clinical governance in military and university hospitals of Kerman/Iran

Mirzaei

Hekmat

Oroomiei

et al. 2019

Health Planning & Management

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Summary Background Over the recent years, clinical governance model has been applied to improve the quality of university and private hospitals in Iran. In addition to university hospitals, military hospitals have an effective role in the preservation and promotion of public health. The challenges of clinical governance implementation have not been investigated in such settings. Hence, the present study objective is to identify the administrative challenges of clinical governance in military and university hospitals of Kerman/Iran Methods This qualitative study was carried out through phenomenology in 2017. A sample of managers and experts in the implementation and execution of clinical governance was purposefully selected from three university hospitals and three military hospitals in Kerman, Iran. A total of 39 managers and experts were interviewed, and data were gathered via semistructured interviews with open questions. For data analysis, conventional content analysis method was employed. Results In this study, five main codes and 17 subcodes were obtained. Main codes were structural challenges, educational challenges, limitations, evaluation, and human resource challenges. Conclusions Clinical governance is being implemented hastily with no appropriate structural, financial, and training facilities, ensuing a waste of resources, more difficult work for staff and a negative view of personnel.

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Section: Discussionsupporting

confidence: 88%

Administrative challenges of clinical governance in military and university hospitals of Kerman/Iran

Mirzaei

Hekmat

Oroomiei

et al. 2019

Health Planning & Management

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“…Designing a system for the evaluation of CG implementation that helps ensure the successful building of the infrastructure and settings required for these goals is an essential matter (17). Different countries have used different models for evaluating their CG systems; these models assess the rate of healthcare organizations' success in implementing CG (18 (22). The results of this study showed that assessing CG implementation has different aspects and is influenced by many factors.…”

Section: Introductionmentioning

confidence: 89%

“…This questionnaire was designed based on the items used for the evaluation of CG implementation in Iran (22). Table 1 show the items used in the Delphi stage.…”

Section: The Item Validating Questionnaire Used For the Evaluation Ofmentioning

confidence: 99%

“…The results of this study showed that assessing CG implementation has different aspects and is influenced by many factors. Since CG is related to change, and change requires money and time, its implementation must be focused on priority areas that are in dire need for the greatest changes (22). In recent years, the MoHME has developed standards for the evaluation of CG implementation; however, it has not set a certain order of priority for them.…”

Section: Introductionmentioning

confidence: 99%

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Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model

Hooshmand

Tourani

Ravaghi

et al. 2015

Int J Health Policy Manag

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Background: The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods: The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. Results:The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. Conclusion: The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety.

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“…The relationship between patients and medical practitioners should be treated as a significant factor of health service delivery, since clinical governance plays an important role in health care markets. Drawing on the concept, Hooshmand, Tourani, Ravaghi, Ebrahimipour maintain that governance models implemented in many hospitals are further motivated by developing realities vis‐à‐vis clinical decision making and sharing of medical information. Hospitals should adopt an integrative approach to governance in health care outlook that improves physician‐patient relationship which would significantly strengthen clinical governance system.…”

Section: Literature Reviewmentioning

confidence: 99%

Do corporate governance mechanisms and internal control systems matter in reducing mortality rates?

Afriyie

Kong

Danso

et al. 2019

Health Planning & Management

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Summary Internal controls are critical to guarding an institution against fraud, error, and devastation. They are effective tools for preventing losses and achieving organizational goals. However, internal control mechanisms need to be relevant, because the organization cannot comprehend the effectiveness of the system if they are out‐of‐touch with the operation. Health care control practices are not exceptionally different from what pertains in other industries. The health care organizations require effective corporate governance mechanisms to uphold their operations and performances. These practices assist health care organizations to exhume cynical practices that generate unproductive results and also factors militating against the hospital's goals or objectives. This study revealed that practices such as enhanced Board diligence, Health Professionals on board, financial prudence, and effective communication have the tendency of reducing mortality, if well executed.

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Challenges in Evaluating Clinical Governance Systems in Iran: A Qualitative Study

Cited by 13 publications

References 38 publications

Administrative challenges of clinical governance in military and university hospitals of Kerman/Iran

Administrative challenges of clinical governance in military and university hospitals of Kerman/Iran

Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model

Do corporate governance mechanisms and internal control systems matter in reducing mortality rates?

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