Search results

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.

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.

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.

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.

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.

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).

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.

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

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.

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

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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

To investigate the association between implementation of clinical governance and patient safety.

A pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementation and the rate of adverse patient safety events (PSE) for 2015 (pre-implementation) and 2017 (post-implementation), across 45 wards in six hospitals were collected. CGS examined compliance with 108 variables, based on the Australian National Safety and Quality Health Service standards. Patient safety was measured as PSE per 100 bed days. Data were analysed using odds ratios to explore the association between patient safety and CGS percentage compliance score.

There was no change in PSE between 2015 and 2017 (MD 0.04 events/100 bed days, 95% CI -0.11 to 0.21). There were higher odds that wards with a CGS score >90% reported reduced PSE, compared to wards with lower compliance. The domains of leadership and culture, risk management and clinical practice had the strongest association with the reduction in PSE.

Given that wards with a CGS score >90% showed increased odds of reduced PSE health service boards need to put in place strategies that engage frontline managers and staff to facilitate full implementation of clinical governance systems for patient safety.

The findings provide evidence that implementation of all facets of CGS in a large public health service is associated with improved patient safety.

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.

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.

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.

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.

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

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.

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.

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

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.

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.

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

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.

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.

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.

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.

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

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.

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.

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.

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

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.

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.

Analysis was confined to published documents.

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