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An investigation of change management processes involved in the implementation of clinical governance by allied health professionals in Scotland
Author(s) -
Hall H.,
Curzio J.
Publication year - 2008
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.425
Subject(s) - context (archaeology) , clinical governance , audit , medical education , psychology , health care , quality (philosophy) , medicine , political science , management , paleontology , philosophy , epistemology , law , biology , economics
Purpose and relevance . Clinical Governance (CG) has been a major ‘change’ initiative for facilitating quality accountability in health care. Responsibilities of Allied Health Professionals (AHPs) within CG have included the application of evidence into practice, risk management, audit, team‐ship and an engagement in the learning underpinning quality‐based care. The purpose of this study was to enlighten change management processes concerning the implementation of CG within AHP practice through: 1) examining the current ‘context of change’ surrounding AHPs and CG; and 2) determining the factors influencing AHP engagement in CG. Methods . A CG questionnaire was devised, peer‐reviewed and piloted in Wales. Subsequently a national survey of 3901 AHPs from 16 Scottish Trusts was undertaken. The sample consisted of a representative grouping of the six largest disciplines (Radiography, Occupational Therapy, Physiotherapy, Dietetics, Speech and Language Therapy and Podiatry). Analysis . Responses from 1714 participants (RR = 44%) were analysed (SPSS, Version 12). Content Analysis was undertaken on the textural data, analysis of variance to compare responses and Multiple Regression to predict the factors influencing AHP engagement in CG. Results . While AHPs were positive about and partially involved in CG, they did not have the appropriate skill, attitude or support to fully engage or take leadership roles in CG. AHPs experienced barriers to instigating change in practice, sharing and putting evidence into practice and to engaging in CG. Differences in perceptions of CG support and attitudes existed between the professions and grades. Certain professions felt significantly more positive and supported in their practice of CG than others. Levels of engagement, awareness, skill, attitude and perceptions of support for CG increased with grade. Part‐timers and newly qualified AHPs were less aware of CG than their full‐time or longer‐qualified AHP colleagues. Five predictors of engagement in CG were found: 1) perception of support for CG; 2) values and belief towards CG; 3) knowledge and skill in CG; 4) grade; and 5) hours of service. Conclusion . A multifaceted ‘change management’ approach, which would increase levels of CG knowledge and skill, provide support and enable positive attitudinal change among AHPs, would be the most successful strategy to facilitate future engagement of Scottish AHPs in CG. Copyright © 2008 John Wiley & Sons, Ltd.