Clinical Governance Infrastructures and Relational Mechanisms of Control in Healthcare Organizations. (June 2014)

• Record Type: Journal Article
• Authors: Bodolica, Virginia; Spraggon, Martin
• Is Part Of: Journal of health management. Volume 16:Number 2(2014:Jun.)
• Page Start: 183
• Page End: 198
• Publication Date: 2014-06
• Subjects: Healthcare markets -- Effectiveness of medical organizations -- Clinical governance -- Relational governance -- Macro-micro decoupling; Health services administration -- India -- Periodicals; 362.1068
• DOI: 10.1177/0972063414526126
• Languages: English
• ISSNs: 0972-0634

Abstract

This review paper aims to identify and discuss the dominant themes surrounding the governance initiatives in the context of medical markets relying on the two most common search strategies, namely the keyword search technique and the ancestry approach. In an in-depth examination of the recently published research in the field we uncover an emergent decoupling between the governance initiatives formulated at the macro- and micro-levels in today's institutions of healthcare provision. The macro-level initiatives are associated with clinical governance infrastructures directed towards the attainment of medical performance targets, whereas the micro-level endeavors refer to relational governance mechanisms for overseeing the relationship between the patient and the physician. Acknowledging the importance of monitoring micro-level interactions that may contribute to the achievement of macro-level objectives, a more comprehensive integration of relational governance devices under the broader system of clinical governance is advocated in this paper with the purpose of enhancing the effectiveness of healthcare organizations.