MAPPING THE LANDSCAPE OF CLINICAL GOVERNANCE MEASUREMENT: A GLOBAL SCOPING REVIEW OF INSTRUMENTS, APPLICATIONS, AND OUTCOMES
Author(s)
LISHA HUANG, M.Sc.; PhD Student1, Chi-tim Hung, M.Sc.2, SHIHAO ZHOU, M.Med.; PhD Student3.
1JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HongKong, China, 2JC School of Public Health and Primary Care, The Chinese University of HongKong, Hong Kong, China, 3JC School of Public Health and Primary Care, The Chinese University of HongKong, HongKong, China.
1JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HongKong, China, 2JC School of Public Health and Primary Care, The Chinese University of HongKong, Hong Kong, China, 3JC School of Public Health and Primary Care, The Chinese University of HongKong, HongKong, China.
OBJECTIVES: Clinical governance (CG) has been widely embraced as a critical strategy for assuring healthcare quality and patient safety over the past three decades, yet the instruments used to measure it remain limited. This review aimed to map the nature, application, and outcomes of instruments developed to measure CG, providing a comprehensive overview to guide instrument selection and future development.
METHODS: A systematic search was conducted in PubMed, CINAHL, Scopus, Embase, PsycINFO and ProQuest databases from inception to April 2026, based on the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. Studies were included if they reported on the application of CG measurement instruments within healthcare settings and were published in English.
RESULTS: Among 8769 screened records, 18 instruments were identified from 47 empirical studies included across 16 countries. Three predominant instruments were utilized in 30 studies: Clinical Governance Climate Questionnaire (CGCQ), Clinical Governance Development Index (CGDI), and Clinical Governance Effectiveness Instrument (CGEI). Across the identified instruments, quality improvement as well as training and development were the most frequently assessed domains, while use of information and staff management remained underrepresented. Notably, three novel domains, leadership and shared decision making, organizational culture, and partnership, have emerged in CG measurement. Instruments spanned public, private, military, psychiatric, and disability service settings, applied across nurses, physicians, allied health professionals, administrators, and managers. However, CG status remained low to moderate globally, and instrument validation and cross cultural adaptation were inadequately reported.
CONCLUSIONS: This review identified a substantial body of CG measurement research, with the CGCQ emerging as the most widely applied instrument. However, strengthening psychometric rigor and establishing standardized benchmarks are warranted to enhance the generalizability and comparability of CG measurement worldwide. Beyond this, empowering bottom-up organizational culture and cultivating intrinsic motivation among frontline staff represent key drivers for advancing CG implementation, ultimately safeguarding healthcare quality and patient safety.
METHODS: A systematic search was conducted in PubMed, CINAHL, Scopus, Embase, PsycINFO and ProQuest databases from inception to April 2026, based on the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. Studies were included if they reported on the application of CG measurement instruments within healthcare settings and were published in English.
RESULTS: Among 8769 screened records, 18 instruments were identified from 47 empirical studies included across 16 countries. Three predominant instruments were utilized in 30 studies: Clinical Governance Climate Questionnaire (CGCQ), Clinical Governance Development Index (CGDI), and Clinical Governance Effectiveness Instrument (CGEI). Across the identified instruments, quality improvement as well as training and development were the most frequently assessed domains, while use of information and staff management remained underrepresented. Notably, three novel domains, leadership and shared decision making, organizational culture, and partnership, have emerged in CG measurement. Instruments spanned public, private, military, psychiatric, and disability service settings, applied across nurses, physicians, allied health professionals, administrators, and managers. However, CG status remained low to moderate globally, and instrument validation and cross cultural adaptation were inadequately reported.
CONCLUSIONS: This review identified a substantial body of CG measurement research, with the CGCQ emerging as the most widely applied instrument. However, strengthening psychometric rigor and establishing standardized benchmarks are warranted to enhance the generalizability and comparability of CG measurement worldwide. Beyond this, empowering bottom-up organizational culture and cultivating intrinsic motivation among frontline staff represent key drivers for advancing CG implementation, ultimately safeguarding healthcare quality and patient safety.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
SA39
Topic
Health Service Delivery & Process of Care, Patient-Centered Research, Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas