ArticleBMC health services research2025
Clinical governance and staffing for healthcare quality: perceptions of nurses, doctors, and senior managers at two tertiary hospitals in Jamaica.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo describe the characteristics of effective workforce and staffing culture among doctors and nurses at two tertiary hospitals in Jamaica, and to explore perceptions of senior managers relating to the health workforce for the delivery of quality care.
methodsA mixed-methods study was done among 216 nurses and 112 doctors, and 17 senior managers. Data on patient safety culture and the effective workforce component were collected for quantitative component. In-depth interviews were done for the qualitative component. Quantitative data were analyzed using descriptive and inferential statistics, and qualitative data were thematically analyzed and compared with selected elements of the quantitative data.
resultsStaffing culture for patient safety among doctors and nurses was poor (35% positive score). More nurses (73.6%) than doctors (34.8%) reported working 40-59 h per week. A higher proportion of nurses (85%) than doctors (67.9%) practiced responsibly with consideration of fatigue and human factors (p = 0.001), with a significant difference by institution (Institution A - 75.0%, Institution B - 81.6%; p = 0.009). Fewer than 70% of respondents reported receiving annual performance appraisals. Qualitative findings revealed issues with staff capacity development, performance management, and persistent staffing challenges, which contributed to gaps in staffing culture for patient safety.
conclusionStaffing culture for patient safety was suboptimal among doctors and nurses. Key challenges identified by senior managers include inadequate staffing, limited capacity development, and weak performance appraisal systems. Strategic investment in workforce development, effective performance management, and evidence-based staffing policies is critical to strengthen clinical governance and achieve quality health care delivery.
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