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The Study Of Influence Of Human Resource Management (HRM) On Implementation Of Clinical Governance In Tehran University Of Medical Sciences Hospitals
Fatemeh Ghazanfari , Hossein Mobaraki ,
Volume 7, Issue 6 (3-2014)
Abstract

Background and Aim: Clinical governance is the application of mechanisms at the right time and place to do tasks for patients properly and obtain maximum clinical results. The implementation of clinical governance definitely requires the skills and inclinations of those working in healthcare sector. The main objective of this study is to identify the relationship between human resource management (HRM) on the one hand and the implementation of clinical governance and the optimal establishment of its framework on the other hand through offering strategies for effective human resource management.

Materials and Methods: This is a descriptive analytical study conducted in a cross-sectional way in 2012. The sampling method was a two-step cluster sampling. Shariati, Imam Khomeini, and Hashemi Nejad were randomly selected from among the hospitals of Tehran University of Medical Sciences (TUMS). The data collection instrument was a researcher-made questionnaire and a checklist. In each hospital, 30 questionnaires were randomly distributed. The gathered data were analyzed by SPSS.

Results: The minimum and maximum scores of clinical governance pertained to Imam Khomeini (594) and Hashemi Nejad (753) hospitals, respectively. Moreover, significant relationships were found between variables of training, recruitment and employment, salaries and benefits on the one hand and clinical governance on the other.

Conclusion : Considering the significant relationship between HRM and the implementation of clinical governance, investment in this aspct of clinical governance as the one that influences success in other aspects can be effective in the establishment of clinical governance.


An Exploration Of Clinical Governance Implementation And Assessment Challenges In Qazvin Teaching Hospitals: A Qualitative Study
Saeed Asefzadeh, Sanaz Taghizadeh, Ali Heyrani , Rafat Mohebbifar, Jalal Arabloo,
Volume 9, Issue 2 (7-2015)
Abstract

Background and Aim: To improve the implementation of clinical governance (CG) in Iran's hospitals, awareness of various aspects of its implementation and assessment is important. The aim of this study was to find out the obstacles and challenges of clinical governance implementation and assessment in Qazvin teaching hospitals. Materials and Methods: Semi-structured interviews with 17 senior managers, clinical staff and clinical governance experts were conducted in six hospitals of Qazvin University of Medical Sciences (QUMS). To analyze the collected data, framework analysis was used. Results: The challenges and obstacles of CG implementation in Qazvin teaching hospitals were explained using three themes of (1) challenges of CG implementation, (2) improvement in seven dimensions of CG, and (3) challenges of CG implementation assessment. Conclusion: The results of this study show that CG implementation needs to address three issues: improving clinical staff awareness about CG, changing organizational culture so as to make it more receptive to CG, and creating higher levels of cooperation among physicians, managers, patients, specialists, and professionals. The supportive role of top management in addressing the three issues and in providing resources and other infrastructures is obviously essent


Impact of Clinical Governance on Patients’ Compliance in Shiraz Public Hospitals
Mohammmad Khammarnia, Zahra Kavosi, Mohadaseh Ghanbari Jahromi, Asra Moradi,
Volume 10, Issue 1 (4-2016)
Abstract

Background and Aim: Hospital complaining is an important dimension of clinical governance. This study aimed to determine the impact of clinical governance program on patients’ complaint in Shiraz public hospitals.

Materials and Methods: This applied study was conducted as descriptive-analytical in 2012 in Shiraz. The population studied was 10 public hospitals in Shiraz and the patients complaints were studied during 5 years. Data collected through Iranian Ministry of Health standard checklist of clinical governance. The data entered to SPSS version 21, and analyzed using descriptive statistics and analytical tests such as Chi-square.

Results: Registered complaints had increasing trend during the execution of the program  and were 1905. Moreover, 60.5% of the complaints have been made by family members. There was significant relationship between complaints registered with the hospital wards (P=0.000) and gender (P=0.000). Therefore, both genders and in all departments of the hospital complaints of poor quality and inappropriate behavior of the staffs was greater than other complaint.

Conclusion: The number of complaints has increased in recent years. It is proposed to reduce the number of complaints attention to improve  communication between physicians and patients, medical ethics, cut non-conventional financial relationaship between physicians and patients, and increased scientific and technical knowledge and skills.


Iran hospital accreditation governance: Challenges and solutions
Ali Mohammad Mosadeghrad, Fatemeh Ghazanfari,
Volume 14, Issue 4 (10-2020)
Abstract
Background and Aim: Hospital accreditation is “an external evaluation of a hospital’s structures, processes, outputs and outcomes by an independent professional accreditation body using pre-established optimum standards”. Accreditation is a strategy for ensuring the quality and, safety of hospital services. An accreditation program’s efficacy depends on the validity of its governance, methods, standards, and surveyors. The Iranian hospital accreditation program faces some challenges. This study aimed to identify the governance challenges of the Iranian hospital accreditation program and its solutions.
Materials and Methods: This qualitative study was performed using semi-structured interviews in 2019. Using a pluralistic evaluation approach, 151 policy makers, accreditation surveyors, hospital managers and staffs, and academics from the ministry of health, medical universities, hospitals and health insurance companies were purposively recuited and interviewed. Thematic analysis was used fordata analysis.
Results: Overall, 23 governance challenges were identified and were grouped into seven categories, i.e., organizational structure, organizational communication, policy making, planning, financing, stewardship and evalutation. Lack of independence, inappropriate organizational structure, resource shortage, senior managers’ mobility and turnover, weak internal and external communication, a compulsory accreditation program, insufficient knowledge of hospital accreditation, and lack of evaluation of the hospital accreditation were the main challenges. Establishing an accreditation council with four idependent scientific, accreditation, appeal and performance evaluation committes, piloting the accreditation program, proper planning, cascade education and training, allocating a specific budet for hospital accreditation, getting the ISQua accreditation certificate and public announcement of hospitals’ accreditation results were proposed as solutions to these challenges.
Conclusion: The governance of Iran's hospital accreditation program faces serious challenges. Improving the governance of the accreditation program leads to achieving the desired results.

Designing a Model for Improving the Country's Health System with an Emphasis on Governance Strategies
Haleh Mohammadiha, Gholam Reza Memarzadeh, Parham Azimi,
Volume 15, Issue 3 (8-2021)
Abstract
Background and Aim: Health systems have played an important role in improving and increasing life expectancy. However, there is a large gap between health systems’ potential and their current performance, most of which relate to governance issues. The purpose of this study is to provide a model for improving the governance of the country's health system.
Materials and Methods: The present study is applied-developmental in terms of purpose. After reviewing the theoretical foundations and previous research, the governance strategies of the health system were identified. Then, using Fuzzy Delphi Method (FDM) and surveying 13 academic and executive experts who were purposefully selected, the research model was designed. Finally, in order to validate the model, 169 managers and specialists of health system departments in Tehran were interviewed with a questionnaire, and the data were analyzed using structural equation modeling (SEM) and SmartPLS software. At this stage, the sampling method was available and the sample size was calculated by Cochran's method.
Results: According to the research findings, in order to promote health governance, 10 main strategies and 58 sub-strategies should be considered. Identified strategies include strategic orientation, optimal financial resource management, stakeholder partnership development, knowledge resource development, administrative health promotion, technical knowledge development, value and ethical orientation, executive and operational platform development, Service delivery capacity management and Balanced and integrated stewardship. Also, the coefficient of determination for the outcome variable is 0.549 and the intensity of the effect of intervening/ facilitating and contextual factors on governance strategies is equal to 0.610 and 0.533, respectively.
Conclusion: The results showed that the governance of the health system is a multifaceted and complex phenomenon and in order to improve it, a set of strategies must be implemented. In addition, it is suggested that according to the issues and threats facing the health system, a roadmap and a long-term plan should be developed in order to move towards the governance model proposed in the present study.

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