Developing clinical governance in a service for people with intellectual disabilities

Abstract

Purpose -Clinical governance has become internationally recognised as a whole-system framework for the continuous improvement of quality in health service delivery. This study aims to explore the issues in implementing a comprehensive clinical governance framework in an organisation that provides services to children and adults with intellectual disabilities supported by a wide range of clinical interventions and therapies. Design/methodology/approach -This was an action research study that utilised a co-operative inquiry approach because of its capacity to facilitate engagement in a collaborative "bottom-up" meets "top-down" process amalgamating theory with organisational priorities to achieve practical and planned change. Action research methodologies use a problem solving approach, focus on real-life issues, and are open and inclusive. The study aimed to identify current practices in inter-disciplinary team working including the measurement and monitoring of quality, and to design collaboratively an integrated team-based service delivery model that focuses on continuous improvement in the quality of clinical services. Findings -The study highlights the benefit of adopting a co-operative inquiry approach to the development of a clinical governance framework. Staff at all levels began to take ownership of the clinical governance agenda. The systemic perspective promoted collaboration across clinical and non-clinical disciplines and it is anticipated that it will result in new approaches to service quality in the organisation in the future. Originality/value -This case study demonstrates how the practical and participatory approach of the action research and co-operative inquiry methodologies can contribute to the resolution of a real organisational issue and enable transformational change in the infrastructure of clinical services.

The chain effect from human resource-based clinical governance through emotional intelligence and CSR to knowledge sharing

“…Moreover, clinical governance, which underscores the value of collaboration, teamwork, and professional partnership (Dewar, 2000;Attree, 2005), promotes cooperative and concordant working practices (Onion, 2000;Som, 2004). Clinical governance therefore enhances collaboration among clinicians as well as between clinicians and patients (Kelleher & McAuliffe, 2012), which leads to higher levels of the dimensions 'social awareness' and 'relationship management' of Goleman's (2001a, b) EI model since social awareness and interpersonal insight are both central to EI (Fisher, 2013). Taken altogether, EI thus can be nurtured through clinical governance initiative as presumed in the following hypothesis:…”

Can Lean Thinking enhance research administration?

“…It is essential to secure the know-how of the personnel and make sure it is properly directed into work processes and customer service. In fact, research evidence suggests that a correlation exists between communication, team performance, and ultimately even service quality [34] . This requires personnel training.…”

Clinical Governance Climate Within Disability Service Organizations from the Perspective of Allied Health Professionals

“…However, the evidence available is anecdotal at best, with no rigorous evaluation of improved practice undertaken. Also, Kelleher and McAuliffe () demonstrated that action research approaches can be used within disability service organizations to identify issues threatening clinical governance within a service. For example, the methodology was used to understand why regular multidisciplinary team meetings were not well attended by clinical staff working within a day service for people with intellectual disability (e.g., the purpose of these meetings was not well articulated to clinical staff, clinician time constraints).…”

“…When conceptualizing systematic approaches to achieve clinical governance within human services, Freeman () argued that increased focus on key performance indicators overshadow the overall aim of clinical governance—organizations become focused on setting key performance indicators (for staff and the service in general) and conceptualizing how to measure performance, as opposed to implementing practices that can support quality care for service users. Kelleher and McAuliffe () also discussed this as an issue in relation to applying clinical governance within disability service organizations. Because of this, Freeman () argued that organizational climate was vital to an organization's capacity to achieve clinical governance (i.e., a climate conducive to supporting staff to undertake tasks and processes related to achieving clinical governance).…”