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Article
Publication date: 27 July 2012

Luu Trong Tuan

This research aims to look through the data of Nhan Dan Gia Dinh Hospital, a state‐owned hospital in Vietnam, for evidence on whether a clinical governance initiative…

Abstract

Purpose

This research aims to look through the data of Nhan Dan Gia Dinh Hospital, a state‐owned hospital in Vietnam, for evidence on whether a clinical governance initiative cultivates ethical leadership, market‐ or innovation‐oriented culture, knowledge sharing, and knowledge‐ or identity‐based trust.

Design/methodology/approach

Data were collected through a case study approach with hospital document collection, field observations, and in‐depth interviews conducted between April 2009 and April 2011.

Findings

The findings demonstrated that a clinical governance initiative, when effectively implemented, can function as a lever for behavioural transformations in the hospital towards ethical leadership, market‐ or innovation‐oriented culture, knowledge sharing, and knowledge‐ or identity‐based trust.

Originality/value

The current research provides a portrayal of an effective clinical governance initiative with its proactive hospital outcomes such as ethical leadership, market‐ or innovation‐oriented culture, knowledge sharing, and knowledge‐ or identity‐based trust on the hospital journey of sustainable health creation. This paper also highlights the necessity for research that examines other organizational outcomes of clinical governance in Vietnamese hospitals of other ownerships.

Details

Clinical Governance: An International Journal, vol. 17 no. 3
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 12 March 2018

Selma Ebrahim

The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act…

Abstract

Purpose

The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act (2007), can enable clinical leadership in mental health settings.

Design/methodology/approach

A questionnaire was completed by clinical psychology and mental health nursing practitioners in a mental health trust in the UK working towards or having gained approved clinician (AC) status, identifying barriers to implementation of the roles and enablers. Qualitative interview data were also gathered with psychiatrists, clinical psychologist and Mental Health Nurse ACs (three in each group).

Findings

There are a number of barriers and enablers of distributed leadership promoted by the MPAC role. Themes identified focused on enabling person-centred care, clinical leadership and culture change more broadly within mental health care. The AC role is supporting clinical leadership by a range of professionals, promoting patient choice by enabling access to clinicians with the appropriate skills to meet needs. Clinical leadership roles are promoting links between organisational priorities, teams and patient care, fostering distributed leadership in practice.

Research limitations/implications

This project reflects the views of a limited number of practitioners within one organisation which limits generalisabilty.

Practical implications

Organisations need clear strategies linked to workforce development and implementation of the roles to capitalise on their potential to support clinical leadership and person-centred care.

Originality/value

This study provides initial qualitative data on potential benefits and challenges of implementing the role.

Details

The Journal of Mental Health Training, Education and Practice, vol. 13 no. 2
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 14 August 2017

Margaret Fry and Anthony Dombkins

Clinical leadership, researcher capacity and a culture of clinical inquiry are needed in the clinical workforce. The purpose of this paper is to report on a program which…

Abstract

Purpose

Clinical leadership, researcher capacity and a culture of clinical inquiry are needed in the clinical workforce. The purpose of this paper is to report on a program which was used to develop and support clinicians to explore practice, implement innovation, translate evidence and build researcher capacity.

Design/methodology/approach

This pragmatic paper presents a case study of a nursing and midwifery clinician-researcher development program. The multi-site, multi-modal program focused on education, mentoring and support, communication networks, and clinician-university partnerships strategies to build workforce capacity and leadership.

Findings

Over 2,000 staff have been involved in the program representing a range of health disciplines. The study day program has been delivered to 500 participants with master classes having over 1,500 attendees. The research mentor program has demonstrated that participants increased their confidence for research leadership roles and are pursuing research and quality assurance projects. Communication strategies improved the visibility of nursing and midwifery.

Research limitations/implications

This case study was conducted in one health district, which may not have relevance to other geographical areas. The small numbers involved in the research mentor program need to be considered when reviewing the findings.

Practical implications

The program has been a catalyst for developing a research culture, clinical leadership and research networks that strengthen workforce capacity. Building researcher skills in the workforce will better support quality healthcare and the examination of everyday practice.

Social implications

Building a culture of healthcare that is based on inquiry and evidence-based practice will lead to more appropriate and consistent healthcare delivery. Consumers have the right to expect health clinicians will challenge everyday practice and have the skills and capability to translate or generate best evidence to underpin professional and service delivery.

Originality/value

This paper provides strategies for building workforce researcher capacity and capability. The program provides opportunity for building research networks and role modeling the value and importance of research to practice and quality improvement.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 31 May 2019

Patience Aseweh Abor

The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case.

Abstract

Purpose

The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case.

Design/methodology/approach

The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication.

Findings

The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients’ reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment.

Practical implications

Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers.

Originality/value

It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals.

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Article
Publication date: 4 December 2017

Peter O’Meara, Gary Wingrove and Michael Nolan

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries…

Abstract

Purpose

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

Design/methodology/approach

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Findings

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

Originality/value

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

Details

International Journal of Health Governance, vol. 22 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

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Article
Publication date: 1 July 2014

Susan A. Nancarrow, Rachael Wade, Anna Moran, Julia Coyle, Jennifer Young and Dianne Boxall

– The purpose of this paper is to analyse existing clinical supervision frameworks to develop a supervision meta-model.

Abstract

Purpose

The purpose of this paper is to analyse existing clinical supervision frameworks to develop a supervision meta-model.

Design/methodology/approach

This research involved a thematic analysis of existing supervision frameworks used to support allied health practitioners working in rural or remote settings in Australia to identify key domains of supervision which could form the basis of supervision framework in this context. A three-tiered sampling approach of the selection of supervision frameworks ensured the direct relevance of the final domains identified to Australian rural allied health practitioners, allied health practitioners generally and to the wider area of health supervision. Thematic analysis was undertaken by Framework analysis methodology using Mindmapping software. The results were organised into a new conceptual model which places the practitioner at the centre of supervision.

Findings

The review included 17 supervision frameworks, encompassing 13 domains of supervision: definitions; purpose and function; supervision models; contexts; content; Modes of engagement; Supervisor attributes; supervisory relationships; supervisor responsibilities; supervisee responsibilities; structures/process for supervision and support; facilitators and barriers; outcomes. The authors developed a reflective, supervision and support framework “Connecting Practice” that is practitioner centred, recognises the tacit and explicit knowledge that staff bring to the relationship, and enables them to identify their own goals and support networks within the context in which they work.

Research limitations/implications

This is a thematic analysis of the literature which was argely based on an analysis of grey literature.

Practical implications

The resulting core domains of supervision provide an evidence-based foundation for the development of clinical supervision models which can be adapted to a range of contexts.

Social implications

An outcome of this paper is a framework called Connecting Practice which organises the domains of supervision in a temporal way, separating those domains that can be modified to improve the supervision framework, from those which are less easily modifiable. This approach is important to help embed the implementation of supervision and support into organisational practice. This paper adds to the existing growing body of work around supervision by helping understand the domains or components that make up the supervisory experience.

Originality/value

Connecting Practice replaces traditional, more hierarchical models of supervision to put the practitioner at the centre of a personalised supervision and support network.

Content available
Article
Publication date: 26 July 2018

Peter O’Meara, Gary Wingrove and Michael McKeage

The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of…

Abstract

Purpose

The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of paramedics and paramedic managers working in North America.

Design/methodology/approach

A case study approach was utilised to describe and analyse paramedic service medical direction in North America and contrast this with the professional self-governance and clinical governance systems operating in other high-income countries. Researchers interviewed participants at two remote North American sites, then completed transcription and thematic analysis.

Findings

Participants identified three themes: first, resourcing, regulatory frameworks and fragmentation; second, independent practice facilitators and barriers; and third, paramedic roles and professionalisation. Those trained outside North America tended to identify self-regulation and clinical governance as the preferred approach to quality management. Few participants had considered paramedicine becoming a self-regulating health profession.

Originality/value

In North America, the “medical direction” model is the dominant approach employed to ensure optimal patient outcomes in paramedic service delivery. In contrast, other comparable countries employ paramedic self-regulatory systems combined with clinical governance to achieve the same ends. This is one of two studies to examine medical direction from the perspective of paramedics and paramedic managers.

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Article
Publication date: 29 November 2019

Hanif Abdul Rahman, Amin Abdul Aziz, Muhamad Adib Ibrahim, Noor-Arpah Suhaili, Ahmad Zahid Daud and Lin Naing

The purpose of this paper is to develop and validate the Islamic Governance Examination tool (IGET) in applicability to the healthcare setting.

Abstract

Purpose

The purpose of this paper is to develop and validate the Islamic Governance Examination tool (IGET) in applicability to the healthcare setting.

Design/methodology/approach

A cross-sectional study using IGET, developed by a panel of expert and extensive literature, which measures Islamic governance (IG) domains – Tauhid, Juristic, Values and Culture. Health and allied health professionals from the largest hospital in Brunei were recruited to establish validity and reliability of the instrument. Structural equation modelling (SEM) was applied to explore the relationship of the IG domains.

Findings

Content validity and construct validity were established with good internal consistency reliability (Cronbach’s α ranged 0.835–0.953). SEM supports the conceptual model and demonstrated potential to improve quality of health services. By articulating internal and organisational processes put in place for compatibility of Muslim patients and accommodating incumbent form of healthcare governance.

Originality/value

To the authors’ knowledge, this is the first study developing, validating and exploring IG components in healthcare setting. Usage of IGET should be cross-validated in different disciplines and settings before application. Nonetheless, IG as a whole need to be developed further to create healthcare environment compatible for Muslim patients and complement current health services to improve health service quality for everyone.

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Article
Publication date: 21 April 2020

Martin Powell

The purpose of the study is to explore how the duty of candour got onto the agenda of the British National Health Service.

Abstract

Purpose

The purpose of the study is to explore how the duty of candour got onto the agenda of the British National Health Service.

Design/methodology/approach

The conceptual approach is based on multiple streams approach, with the methodology being interpretive content analysis, which uses a deductive approach that focuses on both manifest and latent content.

Findings

The duty of candour got onto the NHS agenda as a result of the Mid Staffordshire inquiry report and the long-term “interest group” campaign associated with Robbie's Law. It is argued that the “focusing event” of the Mid Staffordshire Inquiry Report opened the “policy window”. It also highlights the importance of “policy entrepreneur” Sir Robert Francis whose “claim to a hearing”, “political connections” and “persistence” was vital.

Research limitations/implications

Analysis was confined to published documents.

Originality/value

It highlights some of the factors that suggested why the duty of candour got onto the NHS agenda when it did.

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Article
Publication date: 15 September 2020

Brahim Zaadoud, Youness Chbab and Aziz Chaouch

The purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to…

Abstract

Purpose

The purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to compare if the frameworks of performance measurement in primary health care have an influence on performances of health centers.

Design/methodology/approach

We conducted a systematic review of the literature to (1) identify the conceptual framework for measuring quality management systems, (2) assess the effects of conceptual framework on quality improvement and quality of care outcomes. We opted for the frameworks that are more cited in the literature and we analyzed and compared between these frameworks.

Findings

Eight dimensions were identified for assessing performance in Primary Health Care Facilities “PHCF” in more than 50% frameworks: Effectiveness, Safety, Accessibility, Equity, Efficiency, Acceptability, Patient Centeredness and Timeliness.

Research limitations/implications

The limits of this study can be represented by the following elements: (1) lack of exhaustiveness with regard to the current Frameworks. (2) The evaluation of reliability and validity of the qualitative studies remains difficult to appreciate. (3) Most of the evaluation tools of the primary health care are not validated yet. (4) The difference in performance levels between countries, especially for the developed countries and the multitude of the frames of measure of performance, limits the comparability of the results.

Practical implications

This study provides a conceptual and descriptive literature on the different conceptual frameworks for performance measurement in primary health care, and a practical and useful tool for comparison between the different conceptual frameworks. Several organisations of accreditation or certification introduced, developed, incorporated and checked the indicators of clinical quality in the organizations of health care. Some studies revealed links with the governance, the access, the continuity, the coordination, the efficiency and the strength primary care (Dionne Kringos, 2018). Improvements in the quality of care have been observed in the results of accreditation and certification bodies regarding hospital infection control infrastructure, organization and performance.

Originality/value

Even if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Until now, it is not still common to make evaluation of the quality of care in the “PHCF” to obtain the relevant information. The necessity of having performance measurement tools, which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.

Details

International Journal of Health Governance, vol. 25 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

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