Differentiating clinical governance, clinical management and clinical practice

Abstract

PurposeThis paper seeks to review prior definitions of the umbrella term “clinical governance”. The research question is: do clinical governance definitions adequately distinguish between governance, management and practice functions? Three definitions are introduced to replace that umbrella term.Design/methodology/approachContent analysis is applied to analyse 29 definitions of clinical governance from the perspective of the roles and responsibilities of those charged with governance, management and practice.FindingsThe analysis indicates that definitions of the umbrella term “clinical governance” comprise a mixture of activities relating to governance, management and practice which is confusing for those expected to execute those roles.Practical implicationsConsistent with concepts from corporate governance, the paper distinguishes between governance, management and practice. For effective governance, it is important that there be division of duties between governance roles and management and practice roles. These distinctions will help to clarify roles and responsibilities in the execution of clinical activities.Originality/valueDrawing on insights from corporate governance, in particular, the importance of a division of functions between governance roles, and management and practice roles, the paper proposes three new definitions to replace the umbrella term “clinical governance”.

Clinical governance development: learning from the New Zealand experience

“…Others felt that it was necessary to show what specific outcomes clinical governance aimed for. This, of course, speaks to the problems inherent in having a wide variety of definitions of clinical governance in the published literature, as previously noted 6 7. It also implies that it is important for policymakers at different levels of a health system (ie, at central government and the local level) pursuing clinical governance to exactly outline what is intended and to collaborate with health professionals to produce a working definition.…”

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

“…Clinical governance: origins and definition Clinical governance has been widely described elsewhere, including that it has been subject to various definitions which intersect with concepts of "clinical leadership" and "clinical engagement" (Brennan and Flynn, 2013). In brief, clinical governance has become a core policy plank in many countries and health systems since its emergence in the late-1990s in England as described in the now classic Scally and Donaldson article.…”

CGIJ review

“…However, when healthcare professionals are gathered under the clinical governance umbrella, confusion over the mixed metaphors used to describe this quality improvement initiative might be described as "raining" on the healthcare quality parade. Brennan and Flynn (2013) identify a gap between the theory of clinical governance and its implementation in practice. One of the reasons for this, they hypothesise, is confusion over the exact definition of clinical governance.…”