Clinical Governance: An International Journal 

About: Clinical Governance: An International Journal is an academic journal. The journal publishes majorly in the area(s): Clinical governance & Health care. It has an ISSN identifier of 1477-7274. Over the lifetime, 392 publications have been published receiving 3577 citations.

Hospital service quality and its effects on patient satisfaction and behavioural intention

Abstract: Purpose – The purpose of this study is to investigate hospital service quality and its effect on patient satisfaction and behavioural intention.Design/methodology/approach – A convenience sampling technique was used in this study. A total of 350 questionnaires were distributed and 216 were returned (61.7 per cent response rate).Findings – The results confirm that the five dimensions – admission, medical service, overall service, discharge and social responsibility – are a distinct construct for hospital service quality. Each dimension has a significant relationship with hospital service quality. The findings of this study indicate that the establishment of higher levels of hospital service quality will lead customers to have a high level of satisfaction and behavioural intention.Research limitations/implications – This research examined the concept of hospital service quality, patient satisfaction and behavioural intention from the perspective of patients. However, this study did not explore the perspecti...

The effectiveness of orthopaedic triage by extended scope physiotherapists

Abstract: Improving the management of the orthopaedic patient has long been a top priority in healthcare provision in the UK. For the past two decades, successive governments have funded a plethora of “waiting list initiatives” in order to reduce waiting times for both in and outpatients. In recent years, extended scope physiotherapists (ESPs) have become increasingly involved in making clinical management decisions for all orthopaedic patients – a process known as “triaging”. Their effectiveness in this triaging role remains largely untested despite having far reaching implications in terms of service delivery, professional recognition and patient satisfaction. The study is cross‐sectional in design using a survey to retrieve archival outcome data from hospital case notes of patients referred by ESPs for consultant management. The time‐framed sample yielded 170 subjects with a wide range of disorders distributed across all anatomical regions. The data was categorised so that effectiveness could be measured by judging the specificity and appropriateness of referral. Results and the possibility of developing the ESP role to include access to additional investigations and surgical listing are discussed.

Lean and queuing integration for the transformation of health care processes

Abstract: Purpose – Patient satisfaction and quality care are important indicators for the success of any health care enterprise. The critical nature of health care operations entails that some excess capacity is stored in the system to provide the necessary flexibility of response. To prepare health care organizations to deliver high quality services at lower costs, this paper aims to report a lean health care (LEAN‐HC) transformation model that integrates queuing theory and lean methodology to improve the dynamic performance of the health care system.Design/methodology/approach – This paper reviews and evaluates an emergency department health care system that adopts a system dynamic model, redesigned the process using value stream mapping to eliminate non‐value‐added activities to achieve just‐in‐time (JIT) services. This study was conducted at SD Mission Hospital, India. The LEAN‐HC model includes three steps. First, the patient arrival flow is assessed and adjusted, using physicians at the front of the queue to...

Validity and reliability of the CARE Measure in secondary care

Abstract: Purpose – The Consultation and Relational Empathy (CARE) Measure is a validated tool for assessing the patients' perception of the doctors' communication in primary care. The present study aims to evaluate the potential usefulness of the CARE Measure in secondary care in a single Hospital Trust in Scotland.Design/methodology/approach – A total of 1,015 out‐patients attending 25 consultants across ten specialities anonymously completed the questionnaire immediately after their appointment. Overall satisfaction, estimated consultation length, satisfaction with consultation length, and demographic and socio‐economic variables were also recorded.Findings – The number of missing values and “not applicable” responses to the ten CARE Measure items was extremely low (3.4 per cent). Almost 90 per cent of patients felt the CARE Measure items were of major importance. The measure had a high internal reliability (Cronbach's alpha 0.94) and reduced to a single factor. Overall CARE Measure score correlated with overall...

Clinical governance: a fresh look at its definition

Abstract: Clinical governance was introduced in 1997 as a comprehensive framework to improve the healthcare quality in the National Health Service. Since then, the proliferation of various definitions and models of clinical governance illustrates that different perceptions are emerging on clinical governance. However, none of these definitions captures the essence of clinical governance in terms of its organisation‐wide implications for continuous quality improvement. Although there is discrete mention of structure, process and outcomes in the literature on clinical governance, it is hard to find any clear explanation on how clinical governance influences organisational elements. This paper therefore analyses clinical governance in terms of the inputs, processes, structure and the outcomes of healthcare organisations. The fact that the introduction of any new governance framework will have much wider implications for the management of healthcare organisations is illustrated through a refined definition of clinical governance presented in this paper.