Department of Preventive and Social Medicine, Centre for Health Systems, University of Otago, Dunedin, New Zealand.
BMJ Open. 2015 Jan 5;5(1):e006157. doi: 10.1136/bmjopen-2014-006157.
To investigate healthcare professional perceptions of local implementation of a national clinical governance policy in New Zealand.
Respondent comments written at the end of a national healthcare professional survey designed to assess implementation of core components of the clinical governance policy.
The written comments were provided by respondents to a survey distributed to over 41 000 registered healthcare professionals employed in 19 of New Zealand's government-funded District Health Boards. Comments were analysed and categorised within emerging themes.
3205 written comments were received. Five key themes illustrating barriers to clinical governance implementation were found, representing problems with: developing management-clinical relations; clinicians stepping up into clinical governance and leadership activities; interprofessional relations; training needs for governance and leadership; and having insufficient time to get involved.
Despite a national policy on clinical governance which New Zealand's government launched in 2009, this study found that considerable effort is required to build clinical governance at the local level. This finding parallels with other studies in the field. Two areas demand attention: building systems for organisational governance and leadership; and building professional governance arrangements.
调查新西兰医疗保健专业人员对国家临床治理政策在当地实施的看法。
在一项全国性医疗保健专业人员调查结束时，以书面形式征求意见，旨在评估临床治理政策核心要素的实施情况。
书面意见由分布在新西兰 19 个政府资助的地区卫生局的 41000 多名注册医疗保健专业人员的调查中收到。对意见进行了分析，并按照新出现的主题进行了分类。
共收到 3205 条书面意见。发现了 5 个突出的主题，说明了临床治理实施的障碍，这些主题代表了在以下方面存在的问题：发展管理层与临床的关系；临床医生加强临床治理和领导活动；跨专业关系；治理和领导培训需求；以及参与的时间不足。
尽管新西兰政府于 2009 年推出了国家临床治理政策，但本研究发现，需要在地方一级大力建设临床治理。这一发现与该领域的其他研究一致。有两个领域需要关注：建立组织治理和领导制度；以及建立专业治理安排。
