Is medical perspective on clinical governance practices associated with clinical units’ performance and mortality? A cross-sectional study through a record-linkage procedure

Abstract

Objective:Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units’ performance measured through mortality rates and efficiency indicators.Methods:This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors’ knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units’ performance indicators which include patients’ mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators.Results:The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units’ efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units’ mortality rates (odds ratio, −8.677; 95% confidence interval, −16.654, −0.700).Conclusion:The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical governance tools application on its own clinical practice.

Relationship between clinical governance and hospital performance: a cross-sectional study of psychiatric hospitals in Ghana

“…It was, however, interesting to find that there was a positive association between CG and hospital performance. This finding is supported by previous studies in Iran and Italy (Taboli et al, 2014;Sarchielli et al, 2016). This means that investing in CG may help increase hospital performance.…”

“…For example, prior studies found a positive association between CG and quality of care and overall hospital performance (Mousavi et al, 2014;Veenstra et al, 2017). Sarchielli et al (2016) also found that implementation of CG was positively associated with clinical efficiency, including bed occupancy rate, bed turnover interval and reduced mortality. Studies have also shown that there is a positive relationship between CG and job satisfaction.…”

Nursing Professionals’ Perception of Health Care Quality Management

“…Thus, healthcare management through managerial knowledge should be the main axis in the work routine of these professionals. It is essential for the nursing manager to haves knowledge about action planning and organization, clinical governance tools, where the levels of knowledge and application of practices are correlated with e ciency indicators, listed through technical instruments of the work process that underlie decision making and consist of the elaboration of strategies that aim to achieve a de ned objective 14,15 .…”

The challenges of implementation of clinical governance in Iran: a meta-synthesis of qualitative studies

“…Higher quality of healthcare services will satisfy both service providers and the public, besides curbing costs, increasing productivity, and leading to a better organisational performance [5]. Concerns about the quality and safety of services, increased people’s expectations about the health system and its performance, high costs, as well as medical errors have made policy- and decision-makers adopt a new approach to overcome these issues [6, 7].…”

“…This approach is aimed at making management more accountable, and at providing better quality of care. In clinical governance, all stakeholders are actively involved in the continuous improvement of services and delivery of high-quality care within an appropriate environment [6, 7]. Besides the United Kingdom, clinical governance has been implemented in a number of countries, including Indonesia, Canada, Australia and New Zealand, in an attempt to improve services, obtaining positive results [8–11].…”