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Applying and developing health service theory: an empirical study into clinical governance


Greenfield, D and Nugus, P and Fairbrother, G and Milne, J and Debono, D, Applying and developing health service theory: an empirical study into clinical governance, International Journal of Health Governance, 16, (1) pp. 8-19. ISSN 2059-4631 (2011) [Refereed Article]

Copyright Statement

Copyright 2011 Emerald Group Publishing

DOI: doi:10.1108/14777271111104547


Purpose This paper aims to examine an organisation's enactment of clinical governance through applying and advancing a theoretical model. Design/methodology/approach The research site was a large organisation within an autonomous jurisdiction. The study focused on one organisational division. There were nine interviews and 15 focus groups (118 participants). Ethnographic observations totalled 60.5 hours. Document analysis was conducted with organisational reports and website. Data were examined against the model's four attributes and 24 elements, and used to conduct an organisational culture analysis. Findings Analysis showed that a majority of elements, 17 of 24, were strongly identifiable. The remainder were identifiable but not strongly so. Analysis suggested two additions to the model: the inclusion of two elements to an existing attribute and a new attribute and defining elements. This showed that the organisation was working towards, but not yet having achieved, a positive quality and safety culture. In particular, a schism in understanding between managers and frontline staff was noted. Research limitations/implications The study empirically applied and refined a health service theory. The new model, the "clinical governance practice model", can be broadly applied, and can continue to be developed to expand the evidence base for the field. Practical implications Substantively, the study accounts for differences in managerial and frontline staff actions in applying clinical governance. Investigations to understand and identify strategies to bridge the differences are required. Originality/value The study is an original application and refinement of a health service theory. The study identifies that the interpretation of clinical governance, whilst different in different places, gives rise to similar disagreements.

Item Details

Item Type:Refereed Article
Keywords:Clinical governance, Quality, Safety, Organizational culture
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Greenfield, D (Professor David Greenfield)
UTAS Author:Milne, J (Dr Jacqueline Milne)
ID Code:111104
Year Published:2011
Deposited By:TSBE
Deposited On:2016-08-30
Last Modified:2017-11-06

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