Clinical Governance

Author(s):  
Sonya Daniel ◽  
Tom Holmes
Keyword(s):  
2015 ◽  
Vol 20 (2) ◽  
pp. 56-73 ◽  
Author(s):  
Allan D Spigelman ◽  
Shane Rendalls

Purpose – The purpose of this paper is to overview, background and context to clinical governance in Australia, areas for further development and potential learnings for other jurisdictions. Design/methodology/approach – Commentary; non-systematic review of clinical governance literature; review of web sites for national, state and territory health departments, quality and safety organisations, and clinical colleges in Australia. Findings – Clinical governance in Australia shows variation across jurisdictions, reflective of a fragmented health system with responsibility for funding, policy and service provision being divided between levels of government and across service streams. The mechanisms in place to protect and engage with consumers thus varies according to where one lives. Information on quality and safety outcomes also varies; is difficult to find and often does not drill down to a service level useful for informing consumer treatment decisions. Organisational stability was identified as a key success factor in realising and maintaining the cultural shift to deliver ongoing quality. Research limitations/implications – Comparison of quality indicators with clinical governance systems and processes at a hospital level will provide a more detailed understanding of components most influencing quality outcomes. Practical implications – The information reported will assist health service providers to improve information and processes to engage with consumers and build further transparency and accountability. Originality/value – In this paper the authors have included an in depth profile of the background and context for the current state of clinical governance in Australia. The authors expect the detail provided will be of use to the international reader unfamiliar with the nuances of the Australian Healthcare System. Other studies (e.g. Russell and Dawda, 2013; Phillips et al., n.d.) have been based on deep professional understanding of clinical governance in appraising and reporting on initaitives and structures. This review has utilised resources available to an informed consumer seeking to understand the quality and safety of health services.


BDJ ◽  
2021 ◽  
Vol 230 (8) ◽  
pp. 539-543
Author(s):  
Kishan Patel ◽  
Ian Jenkyn
Keyword(s):  

2021 ◽  
Vol 10 (3) ◽  
pp. e001091
Author(s):  
Jenifer Olive Darr ◽  
Richard C Franklin ◽  
Kristin Emma McBain-Rigg ◽  
Sarah Larkins ◽  
Yvette Roe ◽  
...  

BackgroundA national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.AimThe literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?MethodsThematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.ResultsSixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.ConclusionThe ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.


2000 ◽  
Vol 6 (5) ◽  
pp. 373-379 ◽  
Author(s):  
Robert Kehoe

With the arrival of clinical governance, psychiatrists working for the National Health Service (NHS) can no longer work in isolation, and commitment to both clinical effectiveness and continuing professional development (CPD) is expected and likely to become mandatory. Clinical governance gives clinical effectiveness a high priority within NHS organisations, both at primary and secondary care levels, together with clearer lines of accountability.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
N Nargheese ◽  
T Peedika

Abstract Introduction Absolute dysphagia secondary to impacted soft food bolus in oesophagus can occur due to various reasons. Existing pathway was ENT if patient points above the suprasternal notch and GI if below or at the level of notch. Objectives To assess management in patients with soft food bolus dysphagia and reviewing old pathway. Method Data was collected via clinical governance, case notes on track and analysed overall pathway of patients and discussed with the consultants; Paid attention to patients requiring surgical interventions, compared the complications 0f OGD and rigidscopy. Also, effectiveness of Buscopan weighing its adverse effects. Results Total of 147 cases were included, 2 patients from upper GI being secondarily referred to ENT, 18 of ENT with GI, 3.8 of 19% complications has risk of perforations with Rigid scope. 2.6% had risk with OGD with no perforations. 2% needed OGD after rigid. 85% underwent intervention after Buscopan. Conclusions There is no compelling evidence for Buscopan - to be used only for patient satisfaction. Combining Multiple transfers & complex patient journeys causing delay for treatments with less complications of OGD, soft food bolus should be managed by local gastro/gen surgery teams who can provide timely appropriate intervention, ENT involvement only if airway or pharyngeal concern.


2021 ◽  
Vol 14 (3) ◽  
pp. 283
Author(s):  
Félix Lobo ◽  
Isabel Río-Álvarez

Incentives contribute to the proper functioning of the broader contracts that regulate the relationships between health systems and professionals. Likewise, incentives are an important element of clinical governance understood as health services’ management at the micro-level, aimed at achieving better health outcomes for patients. In Spain, monetary and non-monetary incentives are sometimes used in the health services, but not as frequently as in other countries. There are already several examples in European countries of initiatives searching the promotion of biosimilars through different sorts of incentives, but not in Spain. Hence, this paper is aimed at identifying the barriers that incentives to prescribe biosimilars might encounter in Spain, with particular interest in incentives in the framework of clinical governance. Both questions are intertwined. Barriers are presented from two perspectives. Firstly, based on the nature of the barrier: (i) the payment system for health professionals, (ii) budget rigidity and excessive bureaucracy, (iii) little autonomy in the management of human resources (iv) lack of clinical integration, (v) absence of a legal framework for clinical governance, and (vi) other governance-related barriers. The second perspective is based on the stakeholders involved: (i) gaps in knowledge among physicians, (ii) misinformation and distrust among patients, (iii) trade unions opposition to productivity-related payments, (iv) lack of a clear position by professional associations, and (v) misalignment of the goals pursued by some healthcare professionals and the goals of the public system. Finally, the authors advance several recommendations to overcome these barriers at the national level.


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