Clinical governance implementation: a developing country perspective

Akram Khayatzadeh‐Mahani (Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran)
Mahmood Nekoei‐Moghadam (Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran)
Atefeh Esfandiari (Department of Management and Health Economics, Tehran University of Medical Sciences, Tehran, Iran)
Fatemeh Ramezani (Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran)
Sahar Parva (Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran)

Clinical Governance: An International Journal

ISSN: 1477-7274

Publication date: 19 July 2013

Abstract

Purpose

The purpose of this paper is to explore how the clinical governance policy and its main component, patient satisfaction, turned into practice and what they look like on the ground in the centralised health system of Iran.

Design/methodology/approach

A qualitative research stance was adopted incorporating three main sources of information: face to face in‐depth interviews and focus groups conducted with hospital senior managers at the teaching hospitals in Kerman city, Iran, as well as documentary analysis of key policy texts. Nine hospital senior managers were purposefully selected for face‐to‐face interviews as well as a purposeful sample of 15 hospital senior managers for focus groups.

Findings

The documentary analysis revealed how clinical policy has been put into practice. The interview and focus group data analysis also disclosed four key themes with respect to how policy implementers in the Iranian centralised health system perceive nationally developed policies towards clinical governance and patient satisfaction. These include: a paper exercise; opaque, ambiguous policies; unstable policies; and separation of policy making from policy implementation.

Originality/value

The study revealed a perceived mismatch between the official proposals for clinical governance and their application in practice. The findings of this research lend support to the idea that there should be no separation between policy making process and its implementation; they are inseparable and should be treated in parallel, rather than in sequence. The study further suggests more accountability of the state towards its policies and public alike as a better governance of the health system. State‐level sustainability followed by allocating proper resources to implementation fields and empowering policy implementers coupled with good systems of performance control are the keys to keep patient focus a top priority.

Keywords

Citation

Akram Khayatzadeh‐Mahani, Mahmood Nekoei‐Moghadam, Atefeh Esfandiari, Fatemeh Ramezani and Sahar Parva (2013) "Clinical governance implementation: a developing country perspective", Clinical Governance: An International Journal, Vol. 18 No. 3, pp. 186-199

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DOI

: https://doi.org/10.1108/CGIJ-11-2012-0042

Publisher

:

Emerald Group Publishing Limited

Copyright © 2013, Emerald Group Publishing Limited

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