International Journal of Health Policy and Management

International Journal of Health Policy and Management

Governance Must Dive Into Organizations to Make a Real Difference; Comment on “Governance, Government, and the Search for New Provider Models”

Document Type : Commentary

Authors
Jean-Louis Denis 1
Susan Usher 2, 3, 4
1 Canada Research Chair in Governance and Transformation of Health Organizations and Systems, École nationale d’administration publique, Montréal, QC, Canada
2 Health Innovation Forum, Montréal, QC, Canada
3 Institute for Strategic Analysis and Innovation, McGill University Health Centre, Montréal, QC, Canada
4 École nationale d’administration publique, Montréal, QC, Canada
10.15171/ijhpm.2016.89
Abstract
In their 2016 article, Saltman and Duran provide a thoughtful examination of the governance challenges involved in different care delivery models adopted in primary care and hospitals in two European countries. This commentary examines the limited potential of structural changes to achieve real reform and considers that, unless governance arrangements actually succeed in penetrating organizations, they are unlikely to improve care. It proposes three sets of levers influenced by governance that have potential to influence what happens at the point of care: harnessing the autonomy and expertise of professionals at a collective level to work towards better safety and quality; creating enabling contexts for cross-fertilization of clinical and organizational expertise, notably through teamwork; and patient and public engagement to achieve greater agreement on improvement priorities and overcome provider/manager tensions. Good governance provides guidance at a distance but also goes deep enough to influence clinical habits.
Keywords
Governance
Healthcare Reform
Quality Improvement
Subjects
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International Journal of Health Policy and Management
Volume 6, Issue 1
2017
Pages 49-51

  • Received Date 23 April 2016
  • Revised Date 03 July 2016
  • Accepted Date 28 June 2016
  • First Published Date 01 January 2017
  • Published Date 01 January 2017