Clinical governance in operation – everybody's business: a proposed framework

Emerald - 2009
Rajiv KumarSingh1
1Mental Health & Addictions Service, Waikato District Health Board, Hamilton, New Zealand

Tóm tắt

PurposeThe purpose of this paper is to describe a framework for the implementation of clinical governance (CG) within a mental health and addictions service at all functional levels within the system (consumer, clinician, team, service and unit level). It aims to include and enlarge on the functional subdivisions of CG (as practised in the National Health Service (NHS)) by identifying 11 component domains of interest.Design/methodology/approachThe paper briefly reviews the varying interpretations of the concept of CG in the literature and associated difficulties in its implementation.FindingsSeveral authors have pointed out the difficulties in the implementation of CG at the operational level. In particular, CG is often seen as top‐down, “managerial” in its focus rather than providing clinicians at the coal‐face with a device for quality assurance and improvement.Practical implicationsThe framework asserts that the 11 component domains are relevant at all levels within a healthcare delivery system; in fact, conversations already occur around these domains at all levels with variable frequency, with a focus that is relevant to that level, determined by the needs at each level.Originality/valueThe paper describes a practical framework for implementation of CG within a mental health and addictions service that addresses some of the criticism levelled against the concept of CG in the literature. This conceptualisation provides a seamless merging of the so‐called managerial and clinical imperatives around clinical governance.

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Tài liệu tham khảo

Buetow, S.A. and Roland, M. (1999), “Clinical governance: bridging the gap between managerial and clinical approaches to quality of care”, Quality in Health Care, Vol. 8 No. 3, pp. 184‐90.

Degeling, P.J., Maxwell, S., Iedema, R. and Hunter, D.J. (2004), “Making clinical governance work”, British Medical Journal, Vol. 329 No. 7467, pp. 679‐81.

Department of Health (1997), The New NHS: Modern and Dependable, HMSO, London.

Department of Health (2000), An Organisation with a Memory, HMSO, London.

Edwards, N. (2004), “Commentary: model could work”, British Medical Journal, Vol. 329 No. 7467, pp. 681‐2.

Gibson, J.W. and Hodgetts, R.M. (1991), Organisational Communication – A Managerial Perspective, HarperCollins, New York, NY.

James, A. (2005), “How to structure clinical governance”, in James, A., Worral, A. and Kendall, T. (Eds), Clinical Governance in Mental Health and Learning Disability Services – A Practical Guide, Gaskell, London, pp. 27‐43.

Lugon, M. (2005), “Clinical governance – from rhetoric to reality?”, Current Paediatrics, Vol. 15 No. 6, pp. 460‐5.

McSherry, R. and Haddock, J. (1999), “Evidence based health care: its place within clinical governance”, British Journal of Nursing, Vol. 8 No. 2, pp. 113‐17.

McSherry, R. and Pearce, P. (2002), “Introduction and background: clinical governance and the National Health Service”, in McSherry, R. and Pearce, P. (Eds), Clinical Governance: A Guide to Implementation for Health Professionals, Blackwell Science, Oxford, pp. 1‐15.

Mynors‐Wallis, L., Cope, D. and Suliman, S. (2004), “Making clinical governance happen at team level: the Dorset experience”, Clinical Governance: An International Journal, Vol. 9 No. 3, pp. 162‐6.

Nicholls, S., Cullen, R., O'Neill, S. and Halligan, A. (2000), “Clinical governance: its origins and its foundations”, Clinical Performance and Quality Health Care, Vol. 8 No. 3, pp. 172‐8.

O'Connor, N. and Paton, M. (2008), “‘Governance of’ and ‘Governance by’: implementing a clinical governance framework in an area mental health service”, Australasian Psychiatry, Vol. 16 No. 2, pp. 69‐73.

Parker, V., Magner, M., Andersch, N., Alderson, C. and Larney, A. (2003), “Transforming patient care using a clinical governance programme”, Professional Nurse, Vol. 19 No. 1, pp. 24‐7.

Plsek, P.E. and Greenhalgh, T. (2001), “Complexity science: the challenge of complexity in healthcare”, British Medical Journal, Vol. 323 No. 7313, pp. 625‐8.

(The) Quality Improvement Committee (2008), First Report to the Minister of Health: February 2007 to June 2008, The Quality Improvement Committee, Wellington.

Scally, G. and Donaldson, L.J. (1998), “Clinical governance and the drive for quality improvement in the new NHS in England”, British Medical Journal, Vol. 317 No. 7150, pp. 61‐5.

Scott, I.A., Poole, P.J. and Jayathissa, S. (2008), “Improving quality and safety of hospital care: a reappraisal and an agenda for clinically relevant reform”, Internal Medicine Journal, Vol. 38 No. 1, pp. 44‐55.

Shaller, D. (2007), “Patient‐centred care: what does it take?”, available at: www.commonwealthfund.org/usr_doc/Shaller_patient‐centeredcarewhatdoesittake_1067.pdf?section=4039 (accessed 1 September 2008).

Som, C.V. (2004), “Clinical governance: a fresh look at its definition”, Clinical Governance: An International Journal, Vol. 9 No. 2, pp. 87‐90.

Whitty, P.M. (2004), “Prescribing how NHS trusts do quality: a recipe for committees but little action?”, Quality & Safety in Health Care, Vol. 13 No. 5, p. 328.

World Health Organization (WHO) (1985), The Principles of Quality Assurance, Report on a WHO Meeting: Barcelona 1983, Regional Office for Europe, Copenhagen.

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