Clinical governance implementation in a selected teaching emergency department: a systems approach

Implementation Science

Zhaleh Abdi⁴  Abdoljavad Khajavi⁴  Davood Farsi²  Mosadegh Jabbari³  Mojtaba Sedaghat¹  Hamid Ravaghi⁴  Ahmad Barati Marnani⁴  Mohammadreza Maleki⁴  Ali Heyrani⁴ 

[1] Community Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;Emergency Medicine Department, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran;Internal Medicine (Nephrology) Department, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran;Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran

关键词: Soft Systems Methodology;    Quality improvement;    Implementation;    Emergency department;    Clinical governance;   

Others  :  813971
DOI  :  10.1186/1748-5908-7-84

 received in 2012-05-30, accepted in 2012-08-24,  发布年份 2012

【 摘 要 】

Background

Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED).

Methods/design

We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders’ views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies.

Discussion

Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study would contribute to the development of implementation science and be employed by boards and executives governing other clinical settings to facilitate CG implementation.

【 授权许可】

   
2012 Heyrani et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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