Do different approaches to clinical governance development and implementation make a difference? Findings from Ireland and New Zealand
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 9 October 2017
Abstract
Purpose
Clinical governance (CG) is an important foundation for a high-performing health care system, with many countries supporting its development. CG policy may be developed and implemented nationally, or devolved to a local level, with implications for the overall approach to implementation and policy uptake. However, it is not known whether one of these two approaches is more effective. The purpose of this paper is to probe this question. Its setting is Ireland and New Zealand, two broadly comparable countries with similar CG policies. Ireland’s was nationally led, while New Zealand’s was devolved to local districts. This leads to the question of whether these different approaches to implementation make a difference.
Design/methodology/approach
Data from surveys of health professionals in both countries were used to compare performance with CG development.
Findings
The study showed that Ireland’s approach produced a slightly better performance, raising questions about the merits of devolving responsibility for policy implementation to the local level.
Research limitations/implications
The Irish and New Zealand surveys both had lower-than-desirable response rates, which is not uncommon for studies of health professionals such as this. The low response rates mean the findings may be subject to selection bias.
Originality/value
Despite the importance of the question of whether a national or local approach to policy implementation is more effective, few studies specifically focus on this, meaning that this study provides a new contribution to the topic.
Keywords
Acknowledgements
The Irish authors would like to thank Ruth Maher (formally Head of Monitoring QPS Directorate HSE) who collaborated in designing and including the CGDI in the National Patient Safety Culture Survey pilot study and Elaine Fallon for coordinating data collection for the national survey, and assisting in writing individual hospital and the National Report. The authors would also like to give thanks to the project teams, the nominated survey link in each hospital and many staff that contributed by completing the survey. The New Zealand authors are grateful to the National Health Board, Health Quality and Safety Commission and DHBs for supporting this study, and the many respondents for their participation.
Citation
Gauld, R., Horsburgh, S., Flynn, M.A., Carey, D. and Crowley, P. (2017), "Do different approaches to clinical governance development and implementation make a difference? Findings from Ireland and New Zealand", Journal of Health Organization and Management, Vol. 31 No. 7/8, pp. 682-695. https://doi.org/10.1108/JHOM-04-2017-0069
Publisher
:Emerald Publishing Limited
Copyright © 2017, Emerald Publishing Limited