Healthcare Governance and Management

The healthcare organisation is complex and dynamic. This is because its practices are vital because the healthcare systems are increasingly and consistently facing challenges that if they provide no solutions, turmoil happens – and lives become significantly affected. Berg, M., & Black, G. (2014).

Clinical governance and management constitute a necessary framework that aids in the continuum of organisational processes in the pursuit of well-being and health as collective goals. Berends, L. & Crinall, K. (2014), Kickbusch, I. & Gleicher, D. (2017) and Ross, F. and et al. (2014).

Being mindful of the differences between clinical governance and management is crucial. There must be caution and precise boundaries needed to make sure that governance does not become entangled with management. Berends, L. & Crinall, K. (2014). The entire concept of separating health care governor (or board) from healthcare manager can be confusing, but a division of duties must be established to clarify responsibilities and roles in the execution of the activities. Brennan, N. M., & Flynn, M. A. (2013).

To begin with, governing and managing are both influencing from a position of authority. Berends, L. & Crinall, K. (2014) and Scott, L., & Caress, A. (2005). And this is where governance and management become different – governing is more of putting a competent person into a particular position while managing is overseeing the operations. (?)

Healthcare governance deals with the big business picture of a health organisation; it is the body which makes the policies by which the management follows to have standards. It is a system by which managing bodies, managers, clinicians and staff share responsibility and accountability for the quality of care, continuously improving, minimising risks and fostering an environment of excellence in care for patients. Gupte, A., Mclntosh, B., & Sheppy, B. (2012); Gottwald, M. & Landsdown, G. E. (2014); Herd, G., Musaad, S., Herd, G., & Musaad, S. A. (2015).

Whereas, management provides the day-to-day activities of order and consistency of the organisation by following the management process of planning, organising, staffing, directing, and controlling members to ensure that they remain committed to their obligations. Day, G. E., & Leggat, S. G. (2015) and Marquis, B. & Huston, C. (2012).

Multiple published research literature gave different definitions, yet it has a common idea that both bodies must have the principles of transparency, participation, responsiveness, equity, efficiency and effectivity, sustainability and accountability in improving the quality of services and patient safety.  These principles apply to any organisation whether local such as Lakes District Health Board or national like Ministry of Health. Gauld, R. & Horsburgh, S. (2012), Curran, C., & Totten, M. (2010) and Laouer, R. (2011).

Separated, different, hierarchal or not – clinical governance and health care management both define and identify the plans of the organisation as well as implement and put strategies into actions to achieve goals. Kumar, S., Adhish, V. S., Deoki, N. (2014). Although a distinction exists, they share a common goal- about people, and it covers the whole patient’s journey including the horizontal integration across the different levels of services and sector. Dr. Brown, J. and et al. (2009), Bismark, M. M., and et al. (2013), Gillam, S., & Siriwardena, A. N. (2013) and Blegen, N. E., & Severinsson, E. (2011).

Resources:

Bader, B. (2008). Distinguishing governance from management. Retrieved from http://www.canterbury.ac.nz/academicservices/documents/Academic%20Administration%20Workshops/Workshop%201/Distinguishing%20Governance%20from%20Management%20-%20Workshop%201.pdf

Berends, L. & Crinall, K. (2014). Management and Practice in Health and Human services organisations. Victoria, AU: Oxford University Press. p68.

Berg, M., & Black, G. (2014). A Canadian perspective on clinical governance. Clinical Governance: An International Journal, 19(4), 314-321. doi:10.1108/CGIJ-10-2014-0031

Bismark, M. M., Walter, S. J., & Studdert, D. M. (2013). The role of boards in clinical governance: activities and attitudes among members of public health service boards in Victoria. Australian Health Review, 37(5), 682-687. doi:10.1071/AH13125

Blegen, N. E., & Severinsson, E. (2011). Leadership and management in mental health nursing. Journal of Nursing Management, 19(4), 487-497. doi:10.1111/j.1365-2834.2011.01237.x

Brennan, N. M., & Flynn, M. A. (2013). Differentiating clinical governance, clinical management and clinical practice. Clinical Governance: An international journal, 18(2), 114-131. doi:10.1108/14777271311317909

Curran, C., & Totten, M. (2010). Expanding the role of nursing in health care governance. Nursing Economic, 28(1), 44-46.

Day, G. E., & Leggat, S. G. (2015). Leading and managing health services an Australian perspective. Port Melbourne, AU: Cambridge University Press. p5.

Dr. Brown, J. and etal. (2009). Ministerial task group in clinical leadership in good hands – transforming clinical governance in New Zealand. Retrieved from http://www.asms.org.nz/wp-content/uploads/2014/08/In-Good-Hands-2009_151202.pdf

Gauld, R. & Horsburgh, S. (2012). Clinical Governance Assessment Project: Final Report on a National Health Professional Survey and Site Visits to 19 New Zealand DHBs. Dunedin: Centre for Health Systems, University of Otago.

Gillam, S., & Siriwardena, A. N. (2013). Leadership and management for quality. Quality in Primary Care, 21(4), 253-259.

Gottwald, M. & Landsdown, G. E. (2014). Clinical Governance Improving the quality of healthcare for patients and service users. New York, NY: Open University Press. p2.

Gupte, A., Mclntosh, B., & Sheppy, B. (2012). When two worlds collide: Corporate and clinical governance. British Journal of Healthcare Management, 18(12), 619-620.

Herd, G., Musaad, S., Herd, G., & Musaad, S. A. (2015). Clinical governance and point-of-care testing at health provider level. New Zealand Medical Journal, 128(1417), 41-46.

Kickbusch, I. & Gleicher, D. (2017). Governance for health in the 21st century. Retrieved from http://www.euro.who.int/en/publications/abstracts/governance-for-health-in-the-21st-century

Kumar, S., Adhish, V. S., & Deoki, N. (2014). Introduction to Strategic Management and Leadership for Health Professionals. Indian Journal of Community Medicine, 39(1), 13-16. doi:10.4103/0970-0218.126345

Laouer, R. (2011). Physicians in management: a case study of their role in the governance structures in the French hospital boardroom. International Journal of Clinical Leadership, 17(2), 103-109.

Lau, R., Cross, W., Moss, C., Campbell, A., De Castro, M., & Oxley, V. (2014). Leadership and management skills of general practice nurses: Experience or education?. International Journal of Nursing Practice, 20(6), 655-661. doi:10.1111/ijn.12228

Marquis, B. & Huston, C. (2012). Leadership roles and management functions in Nursing. Philadelphia, PA: Lippincott Williams & Wilkins.

Ross, F., Smith, P., Byng, R., Christian, S., Allan, H., Price, L., & Brearley, S. (2014). Learning from people with long-term conditions: New insights for governance in primary healthcare. Health & Social Care in The Community, 22(4), 405-416. doi:10.1111/hsc.12097

Scott, L., & Caress, A. (2005). Shared governance and shared leadership: Meeting the challenges of implementation. Journal of Nursing Management, 13(1), 4-12. doi:10.1111/j.1365-2834.2004.00455.x