Mohaghegh Bahram, Ravaghi Hamid, Mannion Russell, Heidarpoor Peigham, Sajadi Haniye Sadat
Ph.D. of Health Services Management, Assistant Professor. Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
Ph.D. of Heath Policy, Assistant Professor, School of health Management and information sciences, Iran University of Medical Sciences, Tehran, Iran.
Electron Physician. 2016 Jan 15;8(1):1796-803. doi: 10.19082/1796. eCollection 2016 Jan.
Clinical governance as an approach to improving the quality and safety of clinical care has been run in all Iranian hospitals since 2009. This study aimed to provide a comprehensive overview of the processes and challenges faced in implementing clinical governance (CG) in acute-care hospitals in Iran.
We conducted an in-depth, qualitative, multi-case study using semi-structured interviews with a range of key stakeholders and review of relevant documents. This study was conducted in 2011-2012 in six governmental hospitals affiliated with Tehran University of Medical Sciences. The data were analyzed using framework analysis.
The interviewees, predominantly senior managers and nurses, expressed generally positive attitudes towards the benefits of CG. Four out of the six hospitals had a formal strategic plan to implement and execute CG. The emergent barriers to the implementation of CG included insufficient resources, the absence of clear supporting structures, a lack of supportive cultures, and inadequate support from senior management. The main facilitating factors were the reverse of the barriers noted above in addition to developing good relationships with key stakeholders, raising the awareness of CG among staff, and well-designed incentives.
There is a positive sense towards CG, but its successful implementation in Iran will require raising the awareness of CG among staff and key stakeholders and the successful collaboration of internal staff and external agencies.
自2009年起，临床治理作为一种提升临床护理质量与安全的方法已在伊朗所有医院推行。本研究旨在全面概述伊朗急症医院实施临床治理（CG）过程中所面临的流程与挑战。
我们采用半结构化访谈，对一系列关键利益相关者进行深入的定性多案例研究，并查阅相关文件。本研究于2011 - 2012年在德黑兰医科大学附属的六家政府医院开展。数据采用框架分析法进行分析。
受访者主要为高级管理人员和护士，他们对临床治理的益处普遍持积极态度。六家医院中有四家制定了正式的战略计划来实施和执行临床治理。临床治理实施过程中出现的障碍包括资源不足、缺乏明确的支持结构、缺乏支持性文化以及高级管理层支持不足。主要促进因素是上述障碍的反面，此外还包括与关键利益相关者建立良好关系、提高员工对临床治理的认识以及设计良好的激励措施。
人们对临床治理有积极的认识，但在伊朗成功实施临床治理需要提高员工和关键利益相关者对临床治理的认识，以及内部员工与外部机构的成功协作。
