Mapping clinical governance to practitioner roles and responsibilities

J Health Organ Manag. 2020 Dec 18;ahead-of-print(ahead-of-print):18-33. doi: 10.1108/JHOM-02-2020-0065.

Abstract

Purpose: While clinical governance is assumed to be part of organisational structures and policies, implementation of clinical governance in practice (the praxis) can be markedly different. This paper draws on insights from hospital clinicians, managers and governors on how they interpret the term "clinical governance". The influence of best-practice and roles and responsibilities on their interpretations is considered.

Design/methodology/approach: The research is based on 40 in-depth, semi-structured interviews with hospital clinicians, managers and governors from two large academic hospitals in Ireland. The analytical lens for the research is practice theory. Interview transcripts are analysed for practitioners' spoken keywords/terms to explore how practitioners interpret the term "clinical governance". The practice of clinical governance is mapped to front line, management and governance roles and responsibilities.

Findings: The research finds that interpretation of clinical governance in praxis is quite different from best-practice definitions. Practitioner roles and responsibilities held influence practitioners' interpretation.

Originality/value: The research examines interpretations of clinical governance in praxis by clinicians, managers and governors and highlights the adverse consequence of the absence of clear mapping of roles and responsibilities to clinical, management and governance practice.

Keywords: Clinical governance; Governance; Management; Practice; Practice theory; Practitioners; Praxis.