Clinical governance: an assessment of New Zealand’s approach and performance

Abstract

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -Clinical governance policy initiatives have been introduced in many countries and health systems. How to assess development is an important question. The purpose of this paper is to describe and reflect upon the approach taken in New Zealand. Design/methodology/approach -New Zealand's clinical governance policy of 2009 and its implementation through its public health care system are outlined. The authors' assessments, in 2010 and 2012, of this policy are described and key findings summarised. Findings -The implementation of the policy was swift, with considerable commitment across the public health care system to this. The quantitative assessments found reasonable developmental progress between 2010 and 2012. Case studies undertaken in 2012 indicated various areas that policy makers should attend to or build upon in order to better support clinical governance development.Research limitations/implications -Key lessons from New Zealand's clinical governance experience, based on the assessments, include the need for: a well-defined definition of clinical governance; resource materials that can be used by those involved in clinical governance development; recognition that clinical governance development is complicated and takes time; and commitment to new leadership and organisational arrangements. Originality/value -This paper provides useful lessons for policy makers pursuing clinical governance development, derived from two rounds of assessment in New Zealand.

Health reform in Canada

“…There is an ever-increasing emphasis on patient-centred change in developed healthcare systems. Whether the change is new clinical governance practices in New Zealand 10 ); reforming activity-based funding in Sweden and Switzerland, 7 improving mental health practices in Australia 11 or implementing the Accountability Care Act in the US, 12 patient-oriented change is afoot. Yet in Canada change is “stuck.” 7 “Canada’s healthcare systems appeared to be ill-prepared to respond to various shifts in their context … (and there is) … the need for fundamental changes in how healthcare is organized, financed, and delivered.” 8…”

Reported Clinical and Financial Performance of Hospitals With Physician CEOs Compared to Those With Nonphysician CEOs

“…Researchers have studied the degree to which physicians are or should be involved in healthcare leadership, and the results have been mixed (Eagle, 2016; Gauld, 2017; Gauld & Horsburgh, 2015; Goodall, 2011; Goodall et al, 2015; Lega & Sartirana, 2016; Quince et al, 2014; Sarto & Veronesi, 2016; Till et al, 2015). The results indicate that physician leadership at the levels of the board of directors, chief executive, and clinical director may have a salutary effect on the organization’s clinical and financial performance.…”

“…Gauld & Horsburgh, 2015;Goodall, 2011; © 2021 Foundation of the American College of Healthcare Executives. All rights reserved.Hospitals With Physician CEOs Compared to Those With Nonphysician CEOs www.ache.org/journals…”

Emerging structural models for governance of public hospitals

“…The DHBs acts as the board of directors for the public hospitals (Ditzel et al , 2006). They run public hospitals and fund a series of primary health organisations which are responsible for primary care service coordination including general practitioners services within their jurisdiction (Gauld and Horsburgh, 2015). The act provides for establishment of hospital advisory committees to provide complementary advice on issues relating to individual hospitals.…”