title: "Wind of change": the role of human centered healthcare factors in the implementation of clinical governance in an Italian University teaching hospital.
abstract: BACKGROUND
  Clinical governance (CG) is an approach to quality improvement in healthcare aimed at achieving a patient-centered health care system. The main objective of this study was to highlight human centered healthcare latent factors underlying the results of a CG assessment performed in the teaching hospital "A. Gemelli" of Rome, Italy.
  
  
  METHODS
  CG implementation levels were assessed through OPTIGOV© (OPTimizing healthcare GOVernance), a CG scorecard methodology. In order to identify the variables generating latent factors that can influence the governance of the Hospital, the multiple correspondence analysis (MCA) was applied.
  
  
  RESULTS
  The application of OPTIGOV© showed a good CG implementation level in the Gemelli Hospital. By applying MCA, the variables aggregated so as to define 3 latent factors (F1: assessment for people oriented improvement strategy; F2: assessment for people targeted management; F3: tracking for timely accountable people) explaining as a whole 82.68% of the total variance and respectively 48.09% (F1), 24.95% (F2) and 9.64% (F3).
  
  
  CONCLUSIONS
  The heuristic interpretation of the three latent factors could bring back to the concept of humanization in healthcare. This study shows that in the teaching hospital "A. Gemelli" humanization in healthcare is the driver of health care quality improvement.
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Specchia
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Antonio Giulio
authors.initials: AG
authors.lastname: de Belvis
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Parente
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Avolio
authors.affiliation: President, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Damiani
mesh_terms: D054976:Clinical Governance / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D006784:Hospitals, Teaching / Q000458:organization & administration*; D006801:Humans; D007558:Italy; D018802:Patient-Centered Care / Q000458:organization & administration*; D058996:Quality Improvement