Document Type : Original Article
Authors
1 Department of Healthcare Management, Semnan Branch, Islamic Azad University, Semnan, Iran
2 Governance and Health Research Group, Neuroscience Research Institute, Tehran University of Medical Sciences and Health Services, Tehran, Iran Leadership and Governance Scientific Group, Health Managers Development Institute, Ministry of Health and Medical Education, Tehran, Iran
3 Healthcare Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
4 Department of Epidemiology and Biostatistics, Mazandaran University of Medical Sciences, Sari, Iran
Abstract
Clinical governance is a systematic approach to enhancing the quality of primary health care and
ensuring high clinical standards, responsiveness to performance, and continuous improvement
in service quality. The objective of the current study was to investigate the global experiences
of clinical governance in primary health care. In the present systematic review, relevant articles
from different countries were searched in various databases such as MD PubMed from Medline
portal, Emerald Springer link, ProQuest, Cochrane, Scopus, Web of Science, and Consult until
April 2019. The searched articles were checked through CASP and PRISMA checklists, and their
results were extracted. Of the 17 selected studies, 16 belonged to developed countries, including
England (13), Australia, Italy, and New Zealand, and one was from Turkey. The findings were divided
into three general categories: (1) principles of effectiveness and risk management, (2) deployment
requirements such as structural and organizational needs, resource and communication, and
information management, and (3) barriers of clinical governance toward providing primary health
care. it is recommended that a suitable framework or model be developed and designed adapted
to the local culture and taking into account all effective dimensions for a proper establishment and
implementation of clinical governance in primary health care.
Keywords
Publications of the Big Cultural Institute of Ibn Sinai; 2003.
2. Beyrami H, Gholamzadeh Nikjoo R, Jannati A, Jafarabadi M.A,
Dadgar E. Prioritizing quality performance indicators – The
effectiveness of public hospitals using analytical hierarchy
process. Yafteh 2014;16:106‑99.
3. World Health Organization. Integrated Care for Older People:
Realigning Primary Health Care to Respond to Population Ageing. China: World Health Organization; 2018.
4. Park K. Park’s Textbook of Preventive and Social Medicine.
Tehran: Samat; 2007.
5. Serbim A, Paskulin L, Nutbeam D. Improving health literacy
among older people through primary health care units in Brazil:
Feasibility study. Health Promot Int 2020;35(6):1256‑1266.
6. Tabrizi J, Gholamzadeh Nikjoo R. Clinical governance in primary
care; principles, prerequisites and barriers: A systematic review.
J Community Health Res 2013;2:71‑87.
7. Sena AA, dos Santos GA, Almeida LA. Occurrence of HIV and
syphilis in the prenatal care of primary health care. Rev Prev Infec
Saúde 2019;5(3):53‑76.
8. Swerissen H. Strengthening clinical governance in primary health
and community care. Aust J Prim Health 2005;11:2‑3.
9. Allen P. Accountability for clinical governance: Developing
collective responsibility for quality in primary care. BMJ
2000;321:608‑11.
10. Halligan A, Donaldson L. Implementing clinical governance:
Turning vision into reality. BMJ 2001;322:1413‑7.
11. Vassos M, Nankervis K, Chan J. Clinical governance climate
within disability service organizations from the perspective
of allied health professionals. J Policy Pract Intellect Disabil
2019;16:67‑77.
12. Silva M. P33‑Clinical governance in primary health care units‑An
opinion article about statistics on health. J Stat Health Decis
2019;1(1):66‑68.
13. MarshallM, SheaffR, RogersA, Campbell S, Halliwell S, Pickard S,
et al. A qualitative study of the cultural changes in primary care
organisations needed to implement clinical governance. Br J Gen
Pract 2002;52:641‑5.
14. Lock M. Valuing frontline clinician voice in healthcare
governance. A critique of governance and policy documents that
frame clinician engagement in the New South Wales healthcare
system. In: Report to the Clinical Governance Unit, Mid North
Coast Local Health District. Newcastle: Committix Pty, Ltd;
2019.
15. Scally G, Donaldson LJ. Looking forward: Clinical governance and
the drive for quality improvement in the new NHS in England.
BMJ 1998;317:61.
16. Engels Y, Campbell S, Dautzenberg M, van den Hombergh P,
Brinkmann H, Szécsényi J, et al. Developing a framework of, and
quality indicators for, general practice management in Europe.
Fam Pract 2005;22:215‑22.
17. Campbell SM, Braspenning J, HutchinsonA, MarshallM. Research
methods used in developing and applying quality indicators in
primary care. Qual Saf Health Care 2002;11:358‑64.
18. Velandia M, Uvnäs‑Moberg K, Nissen E. Sex differences in
newborn interaction with mother or father during skin‑to‑skin
contact after Caesarean section. Acta Paediatr 2012;101:360‑7.
19. Buja A, Toffanin R, Claus M, Ricciardi W, Damiani G, Baldo V,
et al. Developing a new clinical governance framework for
chronic diseases in primary care: An umbrella review. BMJ Open
2018;8(7):46‑54
20. Jaggs‑Fowler RM. Clinical governance. InnovAiT 201;18(2);54‑59
21. Phillips CB, Pearce CM, Hall S, Travaglia J, de Lusignan S, Love T,
et al. Can clinical governance deliver quality improvement in
Australian general practice and primary care? A systematic review
of the evidence. Med J Aust 2010;193:602‑7.
22. Bodur S, Filiz E. A survey on patient safety culture in
primary healthcare services in Turkey. Int J Qual Health Care
2009;21:348‑55.
23. Gask L, Rogers A, Campbell S, Sheaff R. Beyond the limits of
clinical governance? The case of mental health in English primary
care. BMC Health Serv Res 2008;8:63.
24. Holden L, Moore R. Verifiable cpd paper: The development of
a model and implementation process for clinical governance in
primary dental care. Br Dent J 2004;196:21.
25. Tait AR. Clinical governance in primary care: A literature review.
J Clin Nurs 2004;13:723‑30.
26. Godden S, Majeed A, Pollock A, Bindman AB. How are primary
care groups approaching clinical governance? A review of clinical
governance plans from primary care groups in London. J Public
Health Med 2002;24:165‑9.
27. Campbell SM, Sweeney GM. The role of clinical governance as a
strategy for quality improvement in primary care. Br J Gen Pract
2002;52 Suppl: S12‑7.
28. Pringle M. Clinical governance in primary care: Participating in
clinical governance. BMJ 2000;321:737‑40.
29. Rosen R. Clinical governance in primary care. Improving quality
in the changing world of primary care. BMJ 2000;321:551‑4.
30. McColl A, Roland M. Clinical governance in primary care:
Knowledge and information for clinical governance. BMJ
2000;321:871‑4.
31. McColl A, Roderick P, Smith H, Wilkinson E, Moore M,
Exworthy M, et al. Clinical governance in primary care groups:
The feasibility of deriving evidence‑based performance indicators.
Qual Health Care 2000;9:90‑7.
32. Malcolm L, Mays N. New Zealand’s independent practitioner
associations: A working model of clinical governance in primary
care? BMJ 1999;319:1340‑2.
33. Baker R, Lakhani M, Fraser R, Cheater F. A model for clinical
governance in primary care groups. BMJ 1999;318:779‑83.
34. Campbell SM, Sheaff R, Sibbald B, Marshall MN, Pickard S,
Gask L, et al. Implementing clinical governance in English primary
care groups/trusts: Reconciling quality improvement and quality
assurance. Qual Saf Health Care 2002;11:9‑14.
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