Hospital governance accountability structure: a scoping review

Area of Science:

• Healthcare Management
• Organizational Studies
• Public Health Policy

Background:

• Hospitals face multifaceted challenges in delivering high-quality, safe, and cost-effective services.
• Numerous hospital governance initiatives aim to enhance quality, safety, and accountability.
• Identifying effective hospital governance structures is crucial for addressing these challenges.

Purpose of the Study:

• To identify the critical structures and dimensions that contribute to accountable hospital governance.
• To synthesize existing research on hospital governance and accountability.

Main Methods:

• A scoping review was conducted using Arksey and O'Malley's framework.
• Literature search spanned major databases (PubMed, Web of Science, Embase, Scopus, ProQuest) and search engines from 2010 to 2023.
• Content analysis was employed to analyze 40 selected articles and reports.

Main Results:

• Four primary themes emerged: inclusive governance, commitment to accountability, planning for accountability, and autonomous governance.
• Thirteen subthemes further detailed the features of accountable governance.
• Analysis covered organizational type, source, publication year, objectives, and key findings.

Conclusions:

• Hospital governance reforms globally focus on improving financial and clinical accountability.
• The identified structures and dimensions provide a framework for enhancing hospital accountability.
• Findings can inform policy and practice for more effective hospital governance.