An analysis of how senior management team members have influenced the evolution of clinical governance since A Vision for Change 2006

This qualitative research analyses how senior management team members in the Irish public and independent mental health sectors have influenced the evolution of clinical governance. A 54 item schedule (the Organisational... [ view full abstract ]

This qualitative research analyses how senior management team members in the Irish public and independent mental health sectors have influenced the evolution of clinical governance. A 54 item schedule (the Organisational Progress in Clinical Governance schedule) is utilised to inform a process of semi-structured interviews. A detailed review of the clinical governance literature is undertaken in the first instance to frame the research question and to highlight originality. Newell and Burnard’s ‘Pragmatic Approach to Schematic Content Analysis’ in conjunction with NVivo is used as the data analysis framework. 25 executive and director level senior management team members are interviewed in their capacity as senior leaders and experts in the research area of clinical governance evolution. Five separate healthcare organisations were purposively selected for participation. Senior management team members were drawn from an interdisciplinary perspective. Ethical considerations were reviewed in detail and particular emphasis was placed on maintaining the confidentiality of participation for both interviewees and participating organisations.

Processes to establish the rigour and plausibility of the study are outlined including the use of multiple coding, a reflexive diary and respondent validation. Following data analysis, findings are distilled and presented. The processes through which senior management team members in mental health have influenced clinical governance evolution are delineated. Recommendations for education, practice, management and governance are expounded. These refer to strategies to enhance leadership capacity, commentary on the expanding role of regulation in healthcare, discussion of the differences apparent between HSE and independent sector mental health providers and the implementation of key national policies specifically ICT. Additionally, current issues in recruitment, staff and staff management processes, formal and informal power structures, in-service training and education, evaluation of health service re-structuring at national and regional levels and the re-imagining of strategic alliances with the higher education sector are explored.