Implementing clinical governance in Isfahan hospitals: Barriers and solutions, 2014

Masoud Ferdosi, .; Farhad Bahman Ziyari, .; Mehran Nemat Ollahi, .; Amaneh Rahim Salmani, .; Noureddin Niknam, .

Implementing clinical governance in Isfahan hospitals: Barriers and solutions, 2014

Authors

. Masoud Ferdosi

. Farhad Bahman Ziyari

. Mehran Nemat Ollahi ¹

. Amaneh Rahim Salmani ²

. Noureddin Niknam ²

¹ Quality Improvement Unit, Dr. Ali Shariati Hospital

² Department of Health Services Administration, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: In the new approach, all health care providers have been obligated to maintain
and improve the quality and have been accountable for it. One of the ways is the implementation
of clinical governance (CG). More accurate understanding of its challenges can help to improve
its performance. Aims: In this study, barriers of CG implementation are investigated from
the perspective of the hospitals involved. Besides, some solutions are suggested based on
stakeholders’ opinions. Materials and Methods: This study used combined method (qualitative
content analysis and questionnaire) in hospitals affiliated to Isfahan University of Medical
Sciences in 2014. First, experts, and stakeholders talked about CG implementation obstacles
in a semi‑structured interview. Interviews were confirmed by the interviewee (double check).
After analyzing the interviews using reduction coding the questionnaire was drawn up. The
questionnaire “validity was confirmed by Cronbach’s alpha (0/891)” and its reliability was
obtained using experts confirmation. Data analyzing was performed using SPSS (18) software.
Results: According to results staffing and management factors were the main obstacles.
After them, were factors related to organizational culture, infrastructure elements, information,
sociocultural and then process factors. The learning barriers were in final rank. Thirty‑four
solutions was proposed by experts and divided into subset of eight major barriers. Most solutions
were offered on modifying processes and minimal solutions about modifying of organizational
culture, sociocultural, and educational factors. Conclusion: Removing the obstacles, especially
management and human resource factors can be effective by facilitating and accelerating CG.
Furthermore, use of experts and stakeholders opinions can help to remove CG barriers.

Keywords

Clinical governance

clinical governance team

hospital

Isfahan

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