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

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 refo...

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Detalles Bibliográficos
Autores principales: Denis, Jean-Louis, Usher, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193506/
https://www.ncbi.nlm.nih.gov/pubmed/28005542
http://dx.doi.org/10.15171/ijhpm.2016.89
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author Denis, Jean-Louis
Usher, Susan
author_facet Denis, Jean-Louis
Usher, Susan
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description 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.
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spelling pubmed-51935062016-12-29 Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models" Denis, Jean-Louis Usher, Susan Int J Health Policy Manag Commentary 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. Kerman University of Medical Sciences 2016-07-03 /pmc/articles/PMC5193506/ /pubmed/28005542 http://dx.doi.org/10.15171/ijhpm.2016.89 Text en © 2017 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Commentary
Denis, Jean-Louis
Usher, Susan
Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models"
title Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models"
title_full Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models"
title_fullStr Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models"
title_full_unstemmed Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models"
title_short Governance Must Dive Into Organizations to Make a Real Difference : Comment on "Governance, Government, and the Search for New Provider Models"
title_sort governance must dive into organizations to make a real difference : comment on "governance, government, and the search for new provider models"
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193506/
https://www.ncbi.nlm.nih.gov/pubmed/28005542
http://dx.doi.org/10.15171/ijhpm.2016.89
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