Clinical Governance: An International JournalTable of Contents for Clinical Governance: An International Journal. List of articles from the current issue, including Just Accepted (EarlyCite)https://www.emerald.com/insight/publication/issn/1477-7274/vol/20/iss/4?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestClinical Governance: An International JournalEmerald Publishing LimitedClinical Governance: An International JournalClinical Governance: An International Journalhttps://www.emerald.com/insight/proxy/containerImg?link=/resource/publication/journal/f38e17af426e52daa9587a0d00fe20a2/UNKNOWNhttps://www.emerald.com/insight/publication/issn/1477-7274/vol/20/iss/4?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestPatients versus healthcare providers’ perceptions of quality of carehttps://www.emerald.com/insight/content/doi/10.1108/CGIJ-03-2015-0010/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest– The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals. – A cross-sectional survey of patients seeking outpatient consultations in 17 general hospitals in Ghana was conducted. A total of 818 patients and 152 hospital managers were interviewed. A 22-item quality of care scale was used in data collection. Data were analysed with the aid SPSS version 20. Summary statistics and t-test were used to analyse the data. – There was a significant difference in the overall perception of quality of care between patients and healthcare providers (Patients: M=89.11, SD=11.457; Providers: M=94.60, SD=10.922; t (845) −4.956, p < 001, two-tailed). Also, 18 items out of the 22-item quality of care scale showed significant difference between patients and providers. However, levels of quality of care is generally rated fairly favourably by both category of respondents. – Further study is required to explore the reasons for the perceived quality gaps between patients and healthcare providers. – Management of hospitals need to evaluate patients’ perceptions of quality of care to inform measures aimed at improving quality of care, since what they may consider as good quality service may be rated less favourably by patients. – Comparing perceptions of quality between patients and healthcare providers is important in order adopt measures to address any differences in perceptions of quality between the two stakeholders. To the best of the author’s knowledge no study has been conducted in Ghana to that effect.Patients versus healthcare providers’ perceptions of quality of care
Aaron Asibi Abuosi
Clinical Governance: An International Journal, Vol. 20, No. 4, pp.170-182

– The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals.

– A cross-sectional survey of patients seeking outpatient consultations in 17 general hospitals in Ghana was conducted. A total of 818 patients and 152 hospital managers were interviewed. A 22-item quality of care scale was used in data collection. Data were analysed with the aid SPSS version 20. Summary statistics and t-test were used to analyse the data.

– There was a significant difference in the overall perception of quality of care between patients and healthcare providers (Patients: M=89.11, SD=11.457; Providers: M=94.60, SD=10.922; t (845) −4.956, p < 001, two-tailed). Also, 18 items out of the 22-item quality of care scale showed significant difference between patients and providers. However, levels of quality of care is generally rated fairly favourably by both category of respondents.

– Further study is required to explore the reasons for the perceived quality gaps between patients and healthcare providers.

– Management of hospitals need to evaluate patients’ perceptions of quality of care to inform measures aimed at improving quality of care, since what they may consider as good quality service may be rated less favourably by patients.

– Comparing perceptions of quality between patients and healthcare providers is important in order adopt measures to address any differences in perceptions of quality between the two stakeholders. To the best of the author’s knowledge no study has been conducted in Ghana to that effect.

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Patients versus healthcare providers’ perceptions of quality of care10.1108/CGIJ-03-2015-0010Clinical Governance: An International Journal2015-10-05© 2015 Aaron Asibi AbuosiClinical Governance: An International Journal2042015-10-0510.1108/CGIJ-03-2015-0010https://www.emerald.com/insight/content/doi/10.1108/CGIJ-03-2015-0010/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2015
Nursing experiences of clinical governance implementation: a qualitative studyhttps://www.emerald.com/insight/content/doi/10.1108/CGIJ-03-2015-0009/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest– Clinical governance (CG) was used as a driver to improve safety and quality of healthcare. CG implementing is a change in health system and all the stakeholders must be participating. The purpose of this paper is to study nurses’ experience about CG movement in Tabriz hospitals. – A qualitative study using Focus Group Discussions (FGD) was done. Purposeful Sampling was used to select the objectives including 65 participants. Actually seven FGD’s were held. Content analysis was used to extract the meaningful themes. – It is revealed that nurses are the focal point in CG implementation in hospitals. Low commitment of managers and lack of physicians’ contribution was experienced by nurses. However, personnel education and development and patient safety have got more attention. Blame culture and increased work stress was reported as challenges. – CG as a change in healthcare system, especially in low- and middle-income countries, is faced by several challenges and its implementation would have different experiences. Nursing staff, the major group in hospitals, would be having interesting experiences through CG. Their practical opinions could guide the policy makers to employ proper plans to effectively implement CG. Considering the result of this study in practice would lead to improve CG implementation.Nursing experiences of clinical governance implementation: a qualitative study
Homayoun Sadeghi-Bazargani, Jafar Sadegh Tabrizi, Mohammad Saadati, Roya Hassanzadeh, Gisoo Alizadeh
Clinical Governance: An International Journal, Vol. 20, No. 4, pp.183-190

– Clinical governance (CG) was used as a driver to improve safety and quality of healthcare. CG implementing is a change in health system and all the stakeholders must be participating. The purpose of this paper is to study nurses’ experience about CG movement in Tabriz hospitals.

– A qualitative study using Focus Group Discussions (FGD) was done. Purposeful Sampling was used to select the objectives including 65 participants. Actually seven FGD’s were held. Content analysis was used to extract the meaningful themes.

– It is revealed that nurses are the focal point in CG implementation in hospitals. Low commitment of managers and lack of physicians’ contribution was experienced by nurses. However, personnel education and development and patient safety have got more attention. Blame culture and increased work stress was reported as challenges.

– CG as a change in healthcare system, especially in low- and middle-income countries, is faced by several challenges and its implementation would have different experiences. Nursing staff, the major group in hospitals, would be having interesting experiences through CG. Their practical opinions could guide the policy makers to employ proper plans to effectively implement CG. Considering the result of this study in practice would lead to improve CG implementation.

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Nursing experiences of clinical governance implementation: a qualitative study10.1108/CGIJ-03-2015-0009Clinical Governance: An International Journal2015-10-05© 2015 Homayoun Sadeghi-BazarganiJafar Sadegh TabriziMohammad SaadatiRoya HassanzadehGisoo AlizadehClinical Governance: An International Journal2042015-10-0510.1108/CGIJ-03-2015-0009https://www.emerald.com/insight/content/doi/10.1108/CGIJ-03-2015-0009/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2015
A clinical decisions unit improves emergency general surgery care deliveryhttps://www.emerald.com/insight/content/doi/10.1108/CGIJ-02-2015-0007/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest– Early access to senior decision makers and investigations has improved outcomes for many conditions. A surgical clinical decisions unit (CDU) was created to allow rapid assessment and investigation by on-call senior surgical team members to facilitate decision making and, if appropriate, discharge within a set time frame (less than four hours). The purpose of this paper is to compare outcomes for unscheduled general surgery admissions to the hospital before and after commissioning this unit. – Prospectively collected hospital episode statistics data were compared for all general surgical admissions for one year prior to (July 2010-June 2011) and two years after (July 2011-June 2013) the introduction of the CDU. Statistical analysis using the Mann Whitney U-test was performed. – More patients were discharged within 24 hours (12 per cent vs 20 per cent, p < 0.001) and total hospital stay decreased (4.6 days vs 3.2 days, p < 0.001) following introduction of CDU. Admission via A & E (273 vs 212, p < 0.01) was also decreased. Overall there was a 25.3 per cent reduction in emergency surgical admissions. No difference was noted in 30-day readmission rates (47 vs 49, p=0.29). – The introduction of a CDU in has increased early discharge rates and facilitated safe early discharge, reducing overall hospital stay for unscheduled general surgical admissions. This has decreased fixed bed costs and improved patient flow by decreasing surgical care episodes routed through the emergency department (ED). In all, 30-day readmission rates have not been influenced by shorter hospital stay. Service redesign involving early senior decision making and patient investigation increases efficiency and patient satisfaction within unscheduled general surgical care. Not original but significant in that the model has not been widely implemented and this is a useful addition to the literature.A clinical decisions unit improves emergency general surgery care delivery
Chris Johnstone, Rachel Harwood, Andrew Gilliam, Andrew Mitchell
Clinical Governance: An International Journal, Vol. 20, No. 4, pp.191-198

– Early access to senior decision makers and investigations has improved outcomes for many conditions. A surgical clinical decisions unit (CDU) was created to allow rapid assessment and investigation by on-call senior surgical team members to facilitate decision making and, if appropriate, discharge within a set time frame (less than four hours). The purpose of this paper is to compare outcomes for unscheduled general surgery admissions to the hospital before and after commissioning this unit.

– Prospectively collected hospital episode statistics data were compared for all general surgical admissions for one year prior to (July 2010-June 2011) and two years after (July 2011-June 2013) the introduction of the CDU. Statistical analysis using the Mann Whitney U-test was performed.

– More patients were discharged within 24 hours (12 per cent vs 20 per cent, p < 0.001) and total hospital stay decreased (4.6 days vs 3.2 days, p < 0.001) following introduction of CDU. Admission via A & E (273 vs 212, p < 0.01) was also decreased. Overall there was a 25.3 per cent reduction in emergency surgical admissions. No difference was noted in 30-day readmission rates (47 vs 49, p=0.29).

– The introduction of a CDU in has increased early discharge rates and facilitated safe early discharge, reducing overall hospital stay for unscheduled general surgical admissions. This has decreased fixed bed costs and improved patient flow by decreasing surgical care episodes routed through the emergency department (ED). In all, 30-day readmission rates have not been influenced by shorter hospital stay. Service redesign involving early senior decision making and patient investigation increases efficiency and patient satisfaction within unscheduled general surgical care. Not original but significant in that the model has not been widely implemented and this is a useful addition to the literature.

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A clinical decisions unit improves emergency general surgery care delivery10.1108/CGIJ-02-2015-0007Clinical Governance: An International Journal2015-10-05© 2015 Chris JohnstoneRachel HarwoodAndrew GilliamAndrew MitchellClinical Governance: An International Journal2042015-10-0510.1108/CGIJ-02-2015-0007https://www.emerald.com/insight/content/doi/10.1108/CGIJ-02-2015-0007/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2015
Clinical dashboards and their use in an adult mental health inpatient setting, a pilot studyhttps://www.emerald.com/insight/content/doi/10.1108/CGIJ-06-2015-0019/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest– The purpose of this paper is to explore the experiences and opinions of mental health professionals working in two rehabilitation wards to a clinical dashboard system. – Following the creation of the clinical dashboards, a questionnaire was developed and sent to staff and patients across two clinical wards involved in the clinical dashboard mental health pilot. – The clinical dashboards were viewed as being useful tools for clinicians, supporting engagement. They can offer rapid access to large volumes of clinically useful information, in a palatable format. The pilot suggested that they could be presented in different ways to make them easier to engage with however they could also result in more paperwork for clinicians. – The main limitations included the sample size, responder bias and the limited sampling period. It would have been helpful to have obtained further responses to understand why individuals came to their conclusions. – The development and use of clinical dashboards in a psychiatric rehabilitation setting offered the opportunity to improve quality, collect and respond to relevant clinical data trends: which is regarded positively by staff and patients. – This study represents the first study to examine the use of clinical dashboards within a UK long stay adult mental health ward setting. The results suggest a positive response from both staff and patients and illustrates the potential benefits relating to clinical quality.Clinical dashboards and their use in an adult mental health inpatient setting, a pilot study
Jaspreet Phull, Julie Hall
Clinical Governance: An International Journal, Vol. 20, No. 4, pp.199-207

– The purpose of this paper is to explore the experiences and opinions of mental health professionals working in two rehabilitation wards to a clinical dashboard system.

– Following the creation of the clinical dashboards, a questionnaire was developed and sent to staff and patients across two clinical wards involved in the clinical dashboard mental health pilot.

– The clinical dashboards were viewed as being useful tools for clinicians, supporting engagement. They can offer rapid access to large volumes of clinically useful information, in a palatable format. The pilot suggested that they could be presented in different ways to make them easier to engage with however they could also result in more paperwork for clinicians.

– The main limitations included the sample size, responder bias and the limited sampling period. It would have been helpful to have obtained further responses to understand why individuals came to their conclusions.

– The development and use of clinical dashboards in a psychiatric rehabilitation setting offered the opportunity to improve quality, collect and respond to relevant clinical data trends: which is regarded positively by staff and patients.

– This study represents the first study to examine the use of clinical dashboards within a UK long stay adult mental health ward setting. The results suggest a positive response from both staff and patients and illustrates the potential benefits relating to clinical quality.

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Clinical dashboards and their use in an adult mental health inpatient setting, a pilot study10.1108/CGIJ-06-2015-0019Clinical Governance: An International Journal2015-10-05© 2015 Jaspreet PhullJulie HallClinical Governance: An International Journal2042015-10-0510.1108/CGIJ-06-2015-0019https://www.emerald.com/insight/content/doi/10.1108/CGIJ-06-2015-0019/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2015
Inadvertent returns to theatre within 30 days (IRT30) of surgeryhttps://www.emerald.com/insight/content/doi/10.1108/CGIJ-03-2015-0011/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest– When a patient unexpectedly has to go back to the operating theatre, there is often a perceived problem with the primary operation. An IRT30 is defined as any patient returning to the operating theatre within 30 days of the index procedure. IRT30 has been suggested to be a useful quality indicator of surgical standards and surgeon performance. The purpose of this paper is to evaluate the usefulness of this validated tool, by assessing all IRT30 over a 12-month period. Learning points for individual surgeons, surgical subspecialty units and the clinical governance leads were reviewed. – Consecutive series of general and vascular surgical patients undergoing elective and emergency procedures between July 2012 and 2013. Prospective data collection of all IRT30s classified as Types 1-5 by a single-rater and in-depth discussion of Types 3-5 cases at the clinical governance meetings. The individual case learning points were recorded and the collective data monitored monthly. – There were 134 IRT30s. In total 84 cases were discussed: Type 3 (n=80), Type 4 (n=4) and Type 5 (n=0). In total 50 cases were not discussed: Type 1 (n=27), Type 2 (n=23). – It is crucial that surgeons continue to learn throughout their surgical career by reflecting on their own and their colleague’s results, complications and surgical performance. Analysing Types 3 and 4 IRT30s within the governance meetings has identified learning points related to both surgical technique and surgical decision making. By embracing these learning points, surgical technique and individual as well as group surgeon performance can be modified and opportunities for training and focused supervision created.Inadvertent returns to theatre within 30 days (IRT30) of surgery
Anisha Sukha, Elizabeth Li, Tim Sykes, Anthony Fox, Andrew Schofield, Andrew Houghton
Clinical Governance: An International Journal, Vol. 20, No. 4, pp.208-214

– When a patient unexpectedly has to go back to the operating theatre, there is often a perceived problem with the primary operation. An IRT30 is defined as any patient returning to the operating theatre within 30 days of the index procedure. IRT30 has been suggested to be a useful quality indicator of surgical standards and surgeon performance. The purpose of this paper is to evaluate the usefulness of this validated tool, by assessing all IRT30 over a 12-month period. Learning points for individual surgeons, surgical subspecialty units and the clinical governance leads were reviewed.

– Consecutive series of general and vascular surgical patients undergoing elective and emergency procedures between July 2012 and 2013. Prospective data collection of all IRT30s classified as Types 1-5 by a single-rater and in-depth discussion of Types 3-5 cases at the clinical governance meetings. The individual case learning points were recorded and the collective data monitored monthly.

– There were 134 IRT30s. In total 84 cases were discussed: Type 3 (n=80), Type 4 (n=4) and Type 5 (n=0). In total 50 cases were not discussed: Type 1 (n=27), Type 2 (n=23).

– It is crucial that surgeons continue to learn throughout their surgical career by reflecting on their own and their colleague’s results, complications and surgical performance. Analysing Types 3 and 4 IRT30s within the governance meetings has identified learning points related to both surgical technique and surgical decision making. By embracing these learning points, surgical technique and individual as well as group surgeon performance can be modified and opportunities for training and focused supervision created.

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Inadvertent returns to theatre within 30 days (IRT30) of surgery10.1108/CGIJ-03-2015-0011Clinical Governance: An International Journal2015-10-05© 2015 Anisha SukhaElizabeth LiTim SykesAnthony FoxAndrew SchofieldAndrew HoughtonClinical Governance: An International Journal2042015-10-0510.1108/CGIJ-03-2015-0011https://www.emerald.com/insight/content/doi/10.1108/CGIJ-03-2015-0011/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2015
Clinical Governance Review 20:4https://www.emerald.com/insight/content/doi/10.1108/CGIJ-09-2015-0031/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest– The purpose of this paper is to provide a quick overview of the current journal content. – A review of five papers. – The review section brings together the differing aspects of clinical governance discussed in the current journal. – The review section enables readers to prioritise articles with the most relevance for their needs or particular fields of healthcare.Clinical Governance Review 20:4
Fiona MacVane Phipps
Clinical Governance: An International Journal, Vol. 20, No. 4, pp.215-218

– The purpose of this paper is to provide a quick overview of the current journal content.

– A review of five papers.

– The review section brings together the differing aspects of clinical governance discussed in the current journal.

– The review section enables readers to prioritise articles with the most relevance for their needs or particular fields of healthcare.

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Clinical Governance Review 20:410.1108/CGIJ-09-2015-0031Clinical Governance: An International Journal2015-10-05© 2015 Fiona MacVane PhippsClinical Governance: An International Journal2042015-10-0510.1108/CGIJ-09-2015-0031https://www.emerald.com/insight/content/doi/10.1108/CGIJ-09-2015-0031/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2015