Measuring progress in clinical governance

Freeman, Timothy (2004). Measuring progress in clinical governance. University of Birmingham. Ph.D.

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Abstract

The role of clinical governance within the New Labour NHS reforms of 1997 is to ensure dependable local service delivery of central targets by supporting quality assurance and improvement activities. These twin objectives result in significant tensions, and health care organisations face a difficult balancing act as they seek to align central and local agendas for quality improvement while meeting performance measurement requirements.

The thesis situates clinical governance within broader governance trends, reviewing empirical evaluations of implementation and tracing the effects of internal tensions. It synthesises current literature on applying performance indicators to public sector bureaucracies, and makes a case for the development of two new validated measures of clinical governance: a measure of climate at the level of individual staff (CGCQ); and a competency framework for application at directorate and corporate levels (OPCG).

Following detailed empirical development and assessment of validity and reliability, the measures are applied: the CGCQ to a sample of 1140 participants across four case study sites; and the OPCG to a national sample of 1916 staff from acute, ambulance and mental health / social care trusts. Results indicate the dominance of the quality assurance agenda and the need to support internal quality improvement initiatives.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):