title: Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness.
abstract: OBJECTIVE
  This study has been designed and conducted to develop domestic indicators for evaluating the performance of clinical governance in dimensions of risk management and clinical effectiveness.
  
  
  METHODS
  This study implemented a 5-stage process including conducting a comprehensive literature review, expert panel (∼ 1000 h per person per session, 11 experts), semi-structured interviews, a 2-round Delphi study (33 experts were in attendance) and a final expert panel (8 experts were in attendance).
  
  
  METHODS
  East Azerbaijan-Iran Province.
  
  
  METHODS
  Fifty-six specialists and experts in different fields of medical sciences.
  
  
  METHODS
  Importance and applicability of indicators.
  
  
  RESULTS
  Using a thorough literature review, 361 indicators (129 risk management indicators in 4 dimensions and 232 clinical effectiveness indicators in 18 dimensions) were found. After conducting expert panels and interviews, the number of indicators decreased to 168 cases (65 risk management indicators in 4 dimensions and 103 clinical effectiveness indicators in 12 dimensions). Two rounds of Delphi identified four indicators that were omitted. The members of the final expert panel agreed on 113 indicators (43 risk management indicators in 4 dimensions and 70 clinical effectiveness indicators in 11 dimensions).
  
  
  CONCLUSIONS
  In this study, indicators for assessing clinical governance in domains of risk management and clinical effectiveness were designed that can be used by policy-makers and other authorities for improving the quality of services and evaluating the performance of clinical governance. Those indicators can be used with slight modifications in other countries having healthcare systems similar to that of Iran.
authors.affiliation: Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Saber
authors.initials: S
authors.lastname: Azami-Aghdash
authors.affiliation: Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Jafar Sadegh
authors.initials: JS
authors.lastname: Tabrizi
authors.affiliation: Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Homayoun.sadeghi@gmail.com.
authors.forename: Homayoun
authors.initials: H
authors.lastname: Sadeghi-Bazargani
authors.affiliation: Department of Urology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sakineh
authors.initials: S
authors.lastname: Hajebrahimi
authors.affiliation: Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naghavi-Behzad
mesh_terms: D054976:Clinical Governance / Q000592:standards*; D003697:Delphi Technique; D006801:Humans; D007407:Interviews as Topic; D007492:Iran; D019984:Quality Indicators, Health Care; D012308:Risk Management / Q000592:standards*; D016896:Treatment Outcome
keywords: clinical effectiveness; clinical governance; performance indicators; risk management