Barriers of Clinical Governance Implementation in Tehran Hospitals

Abstract

Background & Objectives: Implementation of clinical governance (CG), as a strategy for improving the quality, safety and effectiveness of health services, has encountered challenges in Iranian hospitals. This study aimed to identify barriers to clinical governance implementation in Tehran hospitals, Tehran, Iran. Methods: This descriptive cross-sectional study was carried out in 92 hospitals in Tehran that had implemented CG in 2014. Data were gathered using a researcher-made questionnaire assessing the human resource, managerial, cultural, procedural and structural barriers of CG. Data analysis was performed through SPSS software (version 20) and using descriptive and inferential statistics. Results: The mean score of CG implementation barriers in Tehran hospitals was 3.36 out of 5. Human resource (mean score: 3.69) and cultural barriers (mean score: 3.02) were the most and least barriers of CG implementation respectively. Simultaneous implementation of accreditation, lack of a continuous improvement culture, staff insufficient motivation, CG bureaucracy and lack of time had respectively the most negative effects on CG implementation. Commitment and participation of senior managers, staff and doctors were low in CG and indeed had a significant relationship with the CG managerial barriers in hospitals. Conclusion: Tehran hospitals encounter many barriers in implementing CG. Policy makers should consider the structure and culture of the hospitals and staff organizational maturity to develop an appropriate CG model. Besides, hospital managers should address the existing barriers and create an appropriate organizational structure and culture to facilitate CG successful implementation. Key­words: Clinical governance, Quality management, Barriers, hospital Citation: Mosadeghrad AM, Shahidi Sadeghi N. Barriers of Clinical Governance Implementation in Tehran Hospitals. Journal of Health Based Research 2018; 3(4): 339-356