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Published in: BMC Health Services Research 1/2010

Open Access 01-12-2010 | Correspondence

OPTIGOV - A new methodology for evaluating Clinical Governance implementation by health providers

Authors: Maria Lucia Specchia, Giuseppe La Torre, Roberta Siliquini, Silvio Capizzi, Luca Valerio, Pierangela Nardella, Alessandro Campana, Walter Ricciardi

Published in: BMC Health Services Research | Issue 1/2010

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Abstract

Background

The aim of Clinical Governance (CG) is to the pursuit of quality in health care through the integration of all the activities impacting on the patient into a single strategy.
OPTIGOV (Optimizing Health Care Governance) is a methodology for the assessment of the level of implementation of CG within healthcare organizations. The aim of this paper is to explain the process underlying the development of OPTIGOV, and describe its characteristics and steps.

Methods

OPTIGOV was developed in 2006 by the Institute of Hygiene of the Catholic University of the Sacred Heart and Eurogroup Consulting Alliance. The main steps of the process were: choice of areas for analysis and questionnaire development, based on a review of scientific literature; assignment of scores and weights to individual questions and areas; implementation of a software interfaceable with Microsoft Office.

Results

OPTIGOV consists of: a) a hospital audit with a structured approach; b) development of an improvement operational plan. A questionnaire divided into 13 areas of analysis is used. For each area there is a form with a variable number of questions and "closed" answers. A score is assigned to each answer, area of analysis, healthcare department and unit. The single scores can be gathered for the organization as a whole.
The software application allows for collation of data, calculation of scores and development of benchmarks to allow comparisons between healthcare organizations. Implementation consists of three stages: the preparation phase includes a kick off meeting, selection of interviewees and development of a survey plan. The registration phase includes hospital audits, reviewing of hospital documentation, data collection and score processing. Lastly, results are processed, inserted into a final report, and discussed in a meeting with the Hospital Board and in a final workshop.

Conclusions

The OPTIGOV methodology for the evaluation of CG implementation was developed with an evidence-based approach. The ongoing adoption of OPTIGOV in several projects will put to the test its potential to realistically represent the organization status, pinpoint criticalities and transferable best practices, provide a plan for improvement, and contribute to triggering changes and pursuit of quality in health care.
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Literature
1.
go back to reference Wright J, Smith ML, Jackson DR: Clinical governance: principles into practice. J Manag Med. 1999, 13 (6): 457-65. 10.1108/02689239910299786.CrossRefPubMed Wright J, Smith ML, Jackson DR: Clinical governance: principles into practice. J Manag Med. 1999, 13 (6): 457-65. 10.1108/02689239910299786.CrossRefPubMed
3.
go back to reference Roland M, Campbell S, Wilkin D: Clinical governance: a convincing strategy for quality improvement?. J Manag Med. 2001, 15 (3): 188-201. 10.1108/02689230110403678.CrossRefPubMed Roland M, Campbell S, Wilkin D: Clinical governance: a convincing strategy for quality improvement?. J Manag Med. 2001, 15 (3): 188-201. 10.1108/02689230110403678.CrossRefPubMed
5.
go back to reference Scally G, Donaldson LJ: The NHS's 50 anniversary. Clinical governance and the drive for quality improvement in the new NHS in England. BMJ. 1998, 317 (7150): 61-5.CrossRefPubMedPubMedCentral Scally G, Donaldson LJ: The NHS's 50 anniversary. Clinical governance and the drive for quality improvement in the new NHS in England. BMJ. 1998, 317 (7150): 61-5.CrossRefPubMedPubMedCentral
7.
go back to reference Deighan M, Bullivant J: NHS Clinical Governance Support Team. Re-energising Clinical Governance through Integrated Governance. Clin Chem Lab Med. 2006, 44 (6): 692-3. 10.1515/CCLM.2006.132.CrossRefPubMed Deighan M, Bullivant J: NHS Clinical Governance Support Team. Re-energising Clinical Governance through Integrated Governance. Clin Chem Lab Med. 2006, 44 (6): 692-3. 10.1515/CCLM.2006.132.CrossRefPubMed
8.
go back to reference Perkins R, Pelkowitz A, Seddon M: EPIQ. Quality improvement in New Zealand healthcare. Part 7: clinical governance--an attempt to bring quality into reality. N Z Med J. 2006, 119 (1243): U2259.PubMed Perkins R, Pelkowitz A, Seddon M: EPIQ. Quality improvement in New Zealand healthcare. Part 7: clinical governance--an attempt to bring quality into reality. N Z Med J. 2006, 119 (1243): U2259.PubMed
9.
go back to reference SteelFisher GK: International innovations in health care: quality improvements in the United Kingdom. Issue Brief (Commonw Fund). 2005, 833: 1-16. SteelFisher GK: International innovations in health care: quality improvements in the United Kingdom. Issue Brief (Commonw Fund). 2005, 833: 1-16.
10.
go back to reference Trabacchi V, Pasquarella C, Signorelli C: Evolution and practical application of the concept of clinical governance in Italy. Ann Ig. 2008, 20 (5): 509-15.PubMed Trabacchi V, Pasquarella C, Signorelli C: Evolution and practical application of the concept of clinical governance in Italy. Ann Ig. 2008, 20 (5): 509-15.PubMed
12.
go back to reference Marshall M, Sheaff R, Rogers A, Campbell S, Halliwell S, Pickard S, Sibbald B, Roland M: A qualitative study of the cultural changes in primary care organizations needed to implement clinical governance. Br J Gen Pract. 2002, 52 (481): 641-5.PubMedPubMedCentral Marshall M, Sheaff R, Rogers A, Campbell S, Halliwell S, Pickard S, Sibbald B, Roland M: A qualitative study of the cultural changes in primary care organizations needed to implement clinical governance. Br J Gen Pract. 2002, 52 (481): 641-5.PubMedPubMedCentral
13.
go back to reference Freeman T, Walshe K: Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England. Qual Saf Health Care. 2004, 13 (5): 335-43. 10.1136/qshc.2002.005108.CrossRefPubMedPubMedCentral Freeman T, Walshe K: Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England. Qual Saf Health Care. 2004, 13 (5): 335-43. 10.1136/qshc.2002.005108.CrossRefPubMedPubMedCentral
14.
go back to reference Allen P: Accountability for clinical governance: developing collective responsibility for quality in primary care. BMJ. 2000, 321 (7261): 608-11. 10.1136/bmj.321.7261.608.CrossRefPubMedPubMedCentral Allen P: Accountability for clinical governance: developing collective responsibility for quality in primary care. BMJ. 2000, 321 (7261): 608-11. 10.1136/bmj.321.7261.608.CrossRefPubMedPubMedCentral
16.
go back to reference Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF: Improving the quality of reports of meta-analyses of randomized controlled trials: the QUOROM statement. Lancet. 1999, 354 (9193): 1896-1900. 10.1016/S0140-6736(99)04149-5.CrossRefPubMed Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF: Improving the quality of reports of meta-analyses of randomized controlled trials: the QUOROM statement. Lancet. 1999, 354 (9193): 1896-1900. 10.1016/S0140-6736(99)04149-5.CrossRefPubMed
17.
go back to reference Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ital J Public Health. 2009, 6 (4): 354-91. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ital J Public Health. 2009, 6 (4): 354-91.
18.
go back to reference Ayres PJ, Wright J, Donaldson LJ: Achieving clinical effectiveness: the new world of clinical governance. Clinician in Management. 1998, 7: 106-11. Ayres PJ, Wright J, Donaldson LJ: Achieving clinical effectiveness: the new world of clinical governance. Clinician in Management. 1998, 7: 106-11.
20.
go back to reference Lugon M, Secker-Walker J: Clinical Governance: making it happen. 1999, London: The Royal Society of Medicine Press Ltd Lugon M, Secker-Walker J: Clinical Governance: making it happen. 1999, London: The Royal Society of Medicine Press Ltd
21.
22.
go back to reference Halligan A, Donaldson L: The meaning and implemention of clinical governance. G Ital Nefrol. 2002, 19 (Spec No 21): S8-13.PubMed Halligan A, Donaldson L: The meaning and implemention of clinical governance. G Ital Nefrol. 2002, 19 (Spec No 21): S8-13.PubMed
23.
go back to reference Sackett D, Straus SE, Richardson WS: Evidence-based medicine: how to practice and teach EBM. 2005, Churchill Livingston, 3 Sackett D, Straus SE, Richardson WS: Evidence-based medicine: how to practice and teach EBM. 2005, Churchill Livingston, 3
24.
go back to reference Freeman T: Measuring progress in clinical governance: assessing the reliability and validity of the Clinical Governance Climate Questionnaire. Health Serv Manage Res. 2003, 16 (4): 234-50. 10.1258/095148403322488937.CrossRefPubMed Freeman T: Measuring progress in clinical governance: assessing the reliability and validity of the Clinical Governance Climate Questionnaire. Health Serv Manage Res. 2003, 16 (4): 234-50. 10.1258/095148403322488937.CrossRefPubMed
25.
go back to reference Godden S, Majeed A, Pollock A, Bindman AB: How are primary care groups approaching clinical governance? A review of clinical governance plans from primary care groups in London. J Public Health Med. 2002, 24 (3): 165-9. 10.1093/pubmed/24.3.165.CrossRefPubMed Godden S, Majeed A, Pollock A, Bindman AB: How are primary care groups approaching clinical governance? A review of clinical governance plans from primary care groups in London. J Public Health Med. 2002, 24 (3): 165-9. 10.1093/pubmed/24.3.165.CrossRefPubMed
26.
go back to reference Hartley AM, Griffiths RK, Saunders KL: An evaluation of clinical governance in the public health departments of the West Midlands Region. J Epidemiol Community Health. 2002, 56 (8): 563-8. 10.1136/jech.56.8.563.CrossRefPubMedPubMedCentral Hartley AM, Griffiths RK, Saunders KL: An evaluation of clinical governance in the public health departments of the West Midlands Region. J Epidemiol Community Health. 2002, 56 (8): 563-8. 10.1136/jech.56.8.563.CrossRefPubMedPubMedCentral
28.
go back to reference Donaldson L, Gray J: Clinical Governance: a quality duty for health organizations. Quality in Health Care. 1998, 7 (suppl): 37-44. Donaldson L, Gray J: Clinical Governance: a quality duty for health organizations. Quality in Health Care. 1998, 7 (suppl): 37-44.
29.
go back to reference Flynn R: Clinical governance and governmentality. Health, Risk and Society. 2002, 4 (2): 155-73. 10.1080/13698570220137042.CrossRef Flynn R: Clinical governance and governmentality. Health, Risk and Society. 2002, 4 (2): 155-73. 10.1080/13698570220137042.CrossRef
30.
go back to reference Flynn R: Soft bureaucracy, governmentality and clinical governance: theoretical approaches to emergent policy. Governing medicine: theory and practice. 2004, Open University Press. Maidenhead: McGraw-Hill International, 11-26. 1 Flynn R: Soft bureaucracy, governmentality and clinical governance: theoretical approaches to emergent policy. Governing medicine: theory and practice. 2004, Open University Press. Maidenhead: McGraw-Hill International, 11-26. 1
31.
go back to reference Iedema R, Braithwaite J, Jorm C, Nugus P, Whelan A: Clinical governance: complexities and promises. Health Care Reform and Industrial Change in Australia: Lessons, Challenges and Implications. Edited by: Stanton P, Willis E, Young S. 2005, Basingstoke: Palgrave McMillan, 253-78. Iedema R, Braithwaite J, Jorm C, Nugus P, Whelan A: Clinical governance: complexities and promises. Health Care Reform and Industrial Change in Australia: Lessons, Challenges and Implications. Edited by: Stanton P, Willis E, Young S. 2005, Basingstoke: Palgrave McMillan, 253-78.
32.
go back to reference Schyve PM: The evolution of external quality evaluation: observation s from the Joint Commission on Accreditation of Healthcare Organizations. Int J Qual Health Care. 2000, 12 (3): 255-8. 10.1093/intqhc/12.3.255.CrossRefPubMed Schyve PM: The evolution of external quality evaluation: observation s from the Joint Commission on Accreditation of Healthcare Organizations. Int J Qual Health Care. 2000, 12 (3): 255-8. 10.1093/intqhc/12.3.255.CrossRefPubMed
33.
go back to reference Donahue KT, vanOstenberg P: Joint Commission International accreditation: relationship to four models of evaluation. Int J Qual Health Care. 2000, 12 (3): 243-6. 10.1093/intqhc/12.3.243.CrossRefPubMed Donahue KT, vanOstenberg P: Joint Commission International accreditation: relationship to four models of evaluation. Int J Qual Health Care. 2000, 12 (3): 243-6. 10.1093/intqhc/12.3.243.CrossRefPubMed
34.
go back to reference Collopy BT, Williams J, Rodgers L, Campbell J, Jenner N, Andrews N: The ACHS Care Evaluation Program: a decade of achievement. Australian Council on Healthcare Standards. J Qual Clin Pract. 2000, 20 (1): 36-41. 10.1046/j.1440-1762.2000.00346.x.CrossRefPubMed Collopy BT, Williams J, Rodgers L, Campbell J, Jenner N, Andrews N: The ACHS Care Evaluation Program: a decade of achievement. Australian Council on Healthcare Standards. J Qual Clin Pract. 2000, 20 (1): 36-41. 10.1046/j.1440-1762.2000.00346.x.CrossRefPubMed
35.
go back to reference Shaw CD: Accreditation and ISO: international convergence on health care standards ISQua position paper--October 1996. Int J Qual Health Care. 1997, 9 (1): 11-3. 10.1093/intqhc/9.1.11.CrossRefPubMed Shaw CD: Accreditation and ISO: international convergence on health care standards ISQua position paper--October 1996. Int J Qual Health Care. 1997, 9 (1): 11-3. 10.1093/intqhc/9.1.11.CrossRefPubMed
36.
go back to reference Braithwaite J: An empirical assessment of social structural and cultural change in clinical directorates. Health Care Anal. 2006, 14 (4): 185-93. 10.1007/s10728-006-0025-5.CrossRefPubMed Braithwaite J: An empirical assessment of social structural and cultural change in clinical directorates. Health Care Anal. 2006, 14 (4): 185-93. 10.1007/s10728-006-0025-5.CrossRefPubMed
37.
go back to reference Braithwaite J, Westbrook MT, Mallock NA, Travaglia JF, Iedema RA: Experiences of health professionals who conducted root cause analyses after undergoing a safety improvement programme. Qual Saf Health Care. 2006, 15 (6): 393-9. 10.1136/qshc.2005.017525.CrossRefPubMedPubMedCentral Braithwaite J, Westbrook MT, Mallock NA, Travaglia JF, Iedema RA: Experiences of health professionals who conducted root cause analyses after undergoing a safety improvement programme. Qual Saf Health Care. 2006, 15 (6): 393-9. 10.1136/qshc.2005.017525.CrossRefPubMedPubMedCentral
38.
go back to reference Korst LM, Signer JM, Aydin CE, Fink A: Identifying organizational capacities and incentives for clinical data-sharing: the case of a regional perinatal information system. J Am Med Inform Assoc. 2008, 15 (2): 195-7. 10.1197/jamia.M2475.CrossRefPubMedPubMedCentral Korst LM, Signer JM, Aydin CE, Fink A: Identifying organizational capacities and incentives for clinical data-sharing: the case of a regional perinatal information system. J Am Med Inform Assoc. 2008, 15 (2): 195-7. 10.1197/jamia.M2475.CrossRefPubMedPubMedCentral
39.
go back to reference Scott L, Caress AL: Shared governance and shared leadership: meeting the challenge of implementation. J Nurs Manag. 2005, 13 (1): 4-12. 10.1111/j.1365-2834.2004.00455.x.CrossRefPubMed Scott L, Caress AL: Shared governance and shared leadership: meeting the challenge of implementation. J Nurs Manag. 2005, 13 (1): 4-12. 10.1111/j.1365-2834.2004.00455.x.CrossRefPubMed
40.
go back to reference Piper IH: Clinical governance, the profession, the 'P' words and responsibility. Ann R Coll Surg Engl. 2000, 82 (Suppl 10): 344-5.PubMed Piper IH: Clinical governance, the profession, the 'P' words and responsibility. Ann R Coll Surg Engl. 2000, 82 (Suppl 10): 344-5.PubMed
41.
go back to reference Scott I: Time for a collective approach from medical specialists to clinical governance. Intern Med J. 2002, 32 (11): 499-501. 10.1046/j.1445-5994.2002.00299.x.CrossRefPubMed Scott I: Time for a collective approach from medical specialists to clinical governance. Intern Med J. 2002, 32 (11): 499-501. 10.1046/j.1445-5994.2002.00299.x.CrossRefPubMed
42.
go back to reference Sausman C: New roles and responsibilities of NHS chief executives in relation to quality and clinical governance. Qual Health Care. 2001, 10 (Suppl 2): 13-20. Sausman C: New roles and responsibilities of NHS chief executives in relation to quality and clinical governance. Qual Health Care. 2001, 10 (Suppl 2): 13-20.
43.
go back to reference Carter YH, Shaw S, Macfarlane F: Primary Care Research Team Assessment (PCRTA): development and evaluation. Occas Pap R Coll Gen Pract. 2002, 81: 1-72. Carter YH, Shaw S, Macfarlane F: Primary Care Research Team Assessment (PCRTA): development and evaluation. Occas Pap R Coll Gen Pract. 2002, 81: 1-72.
44.
go back to reference McConachie H, Logan S, Measure of Process of Care UK Validation Working Group: Validation of the measure of processes of care for use when there is no Child Development Centre. Child Care Health Dev. 2003, 29 (1): 35-45. 10.1046/j.1365-2214.2003.00314.x.CrossRefPubMed McConachie H, Logan S, Measure of Process of Care UK Validation Working Group: Validation of the measure of processes of care for use when there is no Child Development Centre. Child Care Health Dev. 2003, 29 (1): 35-45. 10.1046/j.1365-2214.2003.00314.x.CrossRefPubMed
46.
go back to reference Hill AP, Baeza J: Dealing with things that go wrong. Lancet. 1999, 354 (9196): 2099-100. 10.1016/S0140-6736(99)00443-2.CrossRefPubMed Hill AP, Baeza J: Dealing with things that go wrong. Lancet. 1999, 354 (9196): 2099-100. 10.1016/S0140-6736(99)00443-2.CrossRefPubMed
47.
go back to reference Smith LF, Harris D: Clinical governance--a new label for old ingredients: quality or quantity?. Br J Gen Pract. 1999, 49 (442): 339-40.PubMedPubMedCentral Smith LF, Harris D: Clinical governance--a new label for old ingredients: quality or quantity?. Br J Gen Pract. 1999, 49 (442): 339-40.PubMedPubMedCentral
48.
go back to reference Specchia ML, Nardella P, Capizzi S, Donno S, La Torre G, Siliquini R, Ibba N, Campana A, Rabacchi G, Bertetto G, Ricciardi W: OPTIGOV: a Clinical Governance assessment tool. Results of an experimental programme in Piedmont Region. Clinical Governance. 2008, 4: 19-25. Specchia ML, Nardella P, Capizzi S, Donno S, La Torre G, Siliquini R, Ibba N, Campana A, Rabacchi G, Bertetto G, Ricciardi W: OPTIGOV: a Clinical Governance assessment tool. Results of an experimental programme in Piedmont Region. Clinical Governance. 2008, 4: 19-25.
Metadata
Title
OPTIGOV - A new methodology for evaluating Clinical Governance implementation by health providers
Authors
Maria Lucia Specchia
Giuseppe La Torre
Roberta Siliquini
Silvio Capizzi
Luca Valerio
Pierangela Nardella
Alessandro Campana
Walter Ricciardi
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2010
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-10-174

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