The evolution of clinical governance research: A bibliometric analysis of the healthcare management and nursing literature

Abstract

Clinical governance is an important framework for improving healthcare quality, patient safety, and organizational accountability. This study aimed to map the scientific development and intellectual structure of clinical governance research in health management and nursing. A descriptive and retrospective bibliometric design was used. Data were retrieved from the Web of Science Core Collection and analysed using the bibliometrix package in R and VOSviewer. Of 305 records identified, 287 articles and reviews were included. Publication output generally increased over time, peaking in 2024. The most productive authors contributed two publications each, indicating a dispersed authorship structure, while Australia was the leading country in corresponding-author output. Keyword co-occurrence and thematic analyses identified patient safety, quality improvement, governance mechanisms, and organizational development as the main research domains. Co-citation analysis showed that the field is shaped by interconnected foundations in healthcare quality, patient safety, governance, and organizational management. Overall, clinical governance has evolved from a quality-assurance-oriented concept into a broader interdisciplinary framework linking managerial and frontline clinical practices. Future research should strengthen international and interdisciplinary collaboration and examine underrepresented themes and healthcare contexts to support clinical governance across diverse healthcare systems.