The pursuit of quality: a clinical directorate’s progress in clinical governance a case study of the women and children’s directorate, GUH (HSE)

The aim of the overall study is to inform the design and delivery of a high reliability clinical directorate. This report is the result of the mapping phase in the case study of the Women’s and Children’s Directorate, Galway University Hospitals. It describes the current approach and the hospital’s progress in providing a quality service. The policy context clarifies the external and internal influences affecting the present performance level of the Directorate. The enquiry uses a mixed-method strategy to generate quantitative, qualitative, and documentary evidence. The findings provide perceptions of dimensions of clinical governance, and describe the nature and effects of context as opportunities and constraints on performance. Documentary evidence represents the intended or espoused state of performance, as well as realisation in structure, process and outcomes. Key findings from each method are triangulated on the basis of the emergent qualitative categories. While each method provides its own data set, the combined set of evidence is indicative of the hospital’s theory in use as against its espoused theory. This provides a foundation for the next step, i.e. the reflective phase of the project.