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Does clinical governance influence the appropriateness of hospital stay?

Overview of attention for article published in BMC Health Services Research, April 2015
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Title
Does clinical governance influence the appropriateness of hospital stay?
Published in
BMC Health Services Research, April 2015
DOI 10.1186/s12913-015-0795-2
Pubmed ID
Authors

Maria Lucia Specchia, Andrea Poscia, Massimo Volpe, Paolo Parente, Silvio Capizzi, Andrea Cambieri, Gianfranco Damiani, Walter Ricciardi, OPTIGOV© Collaborating Group, Antonio Giulio De Belvis

Abstract

Clinical Governance provides a framework for assessing and improving clinical quality through a single coherent program. Organizational appropriateness is aimed at achieving the best health outcomes and the most appropriate use of resources. The goal of the present study is to verify the likely relationship between Clinical Governance and appropriateness of hospital stay. A cross-sectional study was conducted in 2012 in an Italian Teaching Hospital. The OPTIGOV(©) (Optimizing Health Care Governance) methodology was used to quantify the level of implementation of Clinical Governance globally and in its main dimensions. Organizational appropriateness was measured retrospectively using the Italian version of the Appropriateness Evaluation Protocol to analyze a random sample of medical records for each clinical unit. Pearson-correlation and multiple linear regression were used to test the relationship between the percentage of inappropriate days of hospital stay and the Clinical Governance implementation levels. 47 Units were assessed. The percentage of inappropriate days of hospital stay showed an inverse correlation with almost all the main Clinical Governance dimensions. Adjusted multiple regression analysis resulted in a significant association between the percentage of inappropriate days and the overall Clinical Governance score (β = -0.28; p < 0.001; R-squared = 0.8). EBM and Clinical Audit represented the Clinical Governance dimensions which had the strongest association with organizational appropriateness. This study suggests that the evaluation of both Clinical Governance and organizational appropriateness through standardized and repeatable tools, such as OPTIGOV(©) and AEP, is a key strategy for healthcare quality. The relationship between the two underlines the central role of Clinical Governance, and especially of EBM and Clinical Audit, in determining a rational improvement of appropriateness levels.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 5 15%
Researcher 4 12%
Other 3 9%
Student > Postgraduate 3 9%
Professor 2 6%
Other 9 26%
Unknown 8 24%
Readers by discipline Count As %
Medicine and Dentistry 10 29%
Nursing and Health Professions 6 18%
Business, Management and Accounting 2 6%
Unspecified 1 3%
Economics, Econometrics and Finance 1 3%
Other 3 9%
Unknown 11 32%