Challenges of Establishing Clinical Governance in the Field of Patient Education: A Qualitative Study

Introduction: Clinical governance is a framework in which service provider organizations are accountable for continuous improvement of responsive quality and protect high service standards by creating an environment where clinical service excellence is flourished. The purpose of this study was to explore challenges of establishing clinical governance in the field of patient education. Methods: This qualitative study was conducted in four teaching hospitals of Tehran University of Medical Sciences and the population consisted of experts involved in the clinical governance program. Sixteen participants were selected using non probability purposive sampling and known cases. Data were collected through semi-structured interviews which were recorded, transcribed and analyzed after informed consent was obtained. Qualitative content analysis was used to analyze the data. Results: Two major themes were emerged: “organization-related and patient-related factors”. Cultural factors included “poor teamwork culture, nurses’ lack of motivation to train patients, unvalued education, lack of time and high workload, shortage of personnel, lack of clear guidelines for education, overtime processes, managers’ neglect of education”. Patient-related factors, included “patients’ unawareness of their legal rights, public predicament and lack of cooperation from patients, patients’ illiteracy and low literacy, low motivation, cultural diversity of patients and difficulty to communicate with them”. Conclusion: Informing patients of their rights to receive comprehensive education and informing caregivers of such rights are the manifestation of patient-orientation concept and could pave the way to remove the challenges of clinical governance program.