Is medical perspective on clinical governance practices associated with clinical units' performance and mortality? A cross-sectional study through a record-linkage procedure

Relationship between clinical governance and hospital performance: a cross-sectional study of psychiatric hospitals in Ghana

Purpose

Clinical governance (CG) is crucial for healthcare quality of care improvement and safeguarding high standards of care. Little is known about CG in sub-Saharan Africa. The authors assessed health workers' perceptions of CG and hospital performance in Ghana's psychiatric hospitals.

Design/methodology/approach

A cross-sectional survey was conducted among 230 health workers across two psychiatric hospitals in Ghana. Data were collected with a structured questionnaire and analyzed with Statistical Package for Social Sciences (SPSS), version 23.0.

Findings

The majority (59.5%) of the respondents were females. The authors found that less than five in ten respondents felt that the hospitals have adopted measures to promote quality assurance (43.2%) and research and development (43.7%). However, a little above half of the respondents felt that the hospitals have adopted measures to promote education and training (57.7%); clinical audit (52.7%); risk management (50.7%) and clinical effectiveness (68.6%). The authors also found a statistically significant association between CG and hospital performance (p < 0.05).

Research limitations/implications

There was a positive relationship between CG and hospital performance. Therefore, investing in CG may help to increase hospital performance.

Originality/value

This is the maiden study to investigate CG and hospital performance in Ghana's psychiatric hospitals and one of the few studies in Africa. This study makes a modest contribution to the global discourse on the subject matter.

The challenges of implementation of clinical governance in Iran: a meta-synthesis of qualitative studies

BACKGROUND

Policy- and decision-makers seek to improve the quality of care in the health sector and therefore aim to improve quality through appropriate policies. Higher quality of care will satisfy service providers and the public, reduce costs, increase productivity, and lead to better organisational performance. Clinical governance is a method through which management can be improved and made more accountable, and leads to the provision of better quality of care. In November 2009, the Iranian Ministry of Health and Medical Education implemented new clinical guidelines to standardise and improve clinical services as well as to increase efficiency and reduce costs. The purpose of this study was to assess the challenges of implementing clinical governance through a meta-synthesis of qualitative studies published in Iran.

METHODS

Ten databases, including ISI/Web of Sciences, PubMed/MEDLINE, Embase, PsycINFO, the Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and the Scientific Information Database, were searched between January 2009 and May 2018. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Thematic synthesis was used to analyse the data.

RESULTS

Ten studies were selected and included based on the inclusion/exclusion criteria. In the first stage, 75 items emerged and were coded, and, following comparison and combination of the codes, 32 codes and 8 themes were finally extracted. These themes included health system structure, management, person-power, cultural factors, information and data, resources, education and evaluation.

CONCLUSION

The findings of the study showed that there exist a variety of challenges for the implementation of clinical governance in Iran. To successfully implement a health policy, its infrastructure needs to be created. Using the views and support of stakeholders can ensure that a policy is well implemented.

TRIAL REGISTRATION

CRD42017079077 . Dated October 10, 2017.