title: [Governance of tertiary referral hospitals in the Democratic Republic of the Congo: a critical interpretive synthesis of the literature].
abstract: BACKGROUND
  Because hospitals are complex enterprises requiring adaptive systems, it is appropriate to apply the theory and terminology of governance or even better adaptive governance to the interpretation of their management. This study focused on understanding hospital governance in Logo, Bunia, and Katana, three hospitals in two regions of the eastern DRC, which has been characterized by intermittent armed conflict since 1996. In such a context of war and continuous insecurity, how can governance be interpreted for hospitals required to adapt to a constantly changing environment to be able to continue to provide health care?
  
  
  METHODS
  A critical interpretive synthesis of the literature, identified by searching for keywords related to governance.
  
  
  RESULTS
  The concepts of governance, adaptive governance, performance, leadership, and complex adaptive system concepts are defined. The interpretation of the concepts helps us to better understand (1) the hospital as a complex adaptive system, (2) the governance of tertiary referral hospitals, (3) analysis of hospital performance, and (4) leadership for good governance of these hospitals.
  
  
  CONCLUSIONS
  The interpretation of these concepts raises several questions about their application to the eastern DRC. Conclusion. This critical interpretive synthesis opens the door to a new way of exploring tertiary hospitals and their governance in the eastern DRC.
authors: Université catholique de Louvain IRSS, 30 clos Chapelle-aux-Champs, 1200 Bruxelles, Belgique.
authors: H
authors: H
authors: Karemere
authors: Cemubac, BP 228 Goma, région du Nord-Kivu, République démocratique du Congo.
authors: J B
authors: JB
authors: Kahindo
authors: Université catholique de Louvain IRSS, 30 clos Chapelle-aux-Champs, 1200 Bruxelles, Belgique.
authors: N
authors: N
authors: Ribesse
authors: Université catholique de Louvain IRSS, 30 clos Chapelle-aux-Champs, 1200 Bruxelles, Belgique.
authors: J
authors: J
authors: Macq
mesh_terms: D054976:Clinical Governance; D003695:Delivery of Health Care / Q000458:organization & administration*; D015023:Democratic Republic of the Congo; D006739:Hospital Administration; D006801:Humans; D007857:Leadership; D012036:Refugees; D062606:Tertiary Care Centers / Q000458:organization & administration*; D014857:Warfare
keywords: Complex System; Democratic Republic of Congo; Governance; Referral hospital; leadership