According to Arnwine (2002), the two pillars that support health care governance are clinical governance and corporate governance. These two sectors of governance have distinct roles and responsibilities, with limitations and advantages inherent in each.
Clinical governance can be defined as the systems, processes, and structures through which health care organizations are held accountable for the quality and safety of patient care (LeSueur, 2017). It focuses on the clinical aspects of health care, including medical decision-making, patient safety, and quality improvement. The main objective of clinical governance is to promote the provision of safe, effective, and efficient care to patients (Walshe & Smith, 2011).
Key components of clinical governance include clinical leadership, quality improvement, risk management, and patient involvement (Institute for Healthcare Improvement, 2019). Clinical leaders play a crucial role in promoting and implementing evidence-based practice, while quality improvement initiatives aim to continuously enhance the delivery of care. Risk management focuses on identifying and mitigating potential risks and adverse events, while patient involvement ensures that the perspectives and preferences of patients are taken into account in decision-making processes.
Corporate governance, on the other hand, refers to the systems and processes through which health care organizations are governed at an organizational level (Chambers, 2012). It focuses on the overall management and strategic direction of the organization, including financial accountability, legal compliance, and stakeholder engagement.
Corporate governance is concerned with the organizational structures, policies, and procedures that guide decision-making and ensure the accountability of management to various stakeholders, such as shareholders, regulators, and the community (Banff Executive Leadership, 2005). It is responsible for setting the vision, mission, and values of the organization, as well as overseeing financial performance, risk management, and compliance with legal and ethical standards.
While clinical governance primarily focuses on patient care and quality improvement, corporate governance is concerned with the overall management and strategic direction of the organization. Clinical governance aims to ensure the provision of safe and effective care, while corporate governance focuses on the organization’s financial performance and compliance with regulatory requirements.
Both clinical governance and corporate governance have their advantages and limitations. Clinical governance promotes patient safety and quality improvement by involving clinicians in decision-making processes and promoting evidence-based practice. It ensures the accountability of health care organizations for the care they provide. However, clinical governance may face challenges in terms of engaging clinicians, implementing change, and measuring quality improvement effectively (Murphy, Peisert, & Murphy, 2015).
On the other hand, corporate governance ensures the financial sustainability and long-term viability of health care organizations. It provides a framework for effective decision-making, risk management, and stakeholder engagement. However, corporate governance may face challenges in terms of balancing the interests of different stakeholders and aligning organizational objectives with clinical priorities (Dowton, 2019).
In conclusion, clinical governance and corporate governance are two distinct sectors of health care governance that play vital roles in ensuring the provision of safe, effective, and efficient care. Clinical governance focuses on the clinical aspects of care and aims to promote quality improvement, patient safety, and evidence-based practice. Corporate governance, on the other hand, is concerned with the overall management and strategic direction of the organization, including financial accountability and stakeholder engagement. While both sectors have their advantages and limitations, effective governance requires a balance between clinical and corporate priorities to achieve the best outcomes for patients and organizations.
