Multi-Hospital Surveys: Investigating Health Professional Perceptions of Clinical Governance and Healthcare Quality and Safety

2017 ◽  
Author(s):  
Robin Gauld
Keyword(s):  
Health Professional ◽  
Healthcare Quality ◽  
Clinical Governance ◽  
Quality And Safety ◽  
Professional Perceptions

scholarly journals Health professional networks as a vector for improving healthcare quality and safety: a systematic review

2011 ◽  
Vol 21 (3) ◽  
pp. 239-249 ◽  
Author(s):  
Frances C Cunningham ◽  
Geetha Ranmuthugala ◽  
Jennifer Plumb ◽  
Andrew Georgiou ◽  
Johanna I Westbrook ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Professional ◽  
Healthcare Quality ◽  
Quality And Safety ◽  
Professional Networks

Clinical governance in Australia

2015 ◽  
Vol 20 (2) ◽  
pp. 56-73 ◽  
Author(s):  
Allan D Spigelman ◽  
Shane Rendalls
Keyword(s):  
Web Sites ◽  
Service Providers ◽  
Service Level ◽  
Clinical Governance ◽  
Success Factor ◽  
Quality And Safety ◽  
Funding Policy ◽  
Content Type ◽  
Health Service Providers ◽  
Governance Systems

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.

scholarly journals Supporting the mental health of mothers of children with a disability: Health professional perceptions of need, role, and challenges

2018 ◽  
Vol 44 (5) ◽  
pp. 721-729 ◽  
Author(s):  
Kim-Michelle Gilson ◽  
Shae Johnson ◽  
Elise Davis ◽  
Susan Brunton ◽  
Elena Swift ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Professional Perceptions

scholarly journals Conclusion: the road ahead: where should we go now to improve healthcare quality in acute settings?

2019 ◽  
Vol 32 (Supplement_1) ◽  
pp. 99-103 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Natalie Taylor ◽  
Robyn Clay-Williams ◽  
Hsuen P Ting ◽  
Gaston Arnolda
Keyword(s):  
Quality Improvement ◽  
Healthcare Quality ◽  
Quality And Safety ◽  
Future Studies ◽  
The Road ◽  
The Core ◽  
Depth Analysis ◽  
No Gold Standard ◽  
Main Message ◽  
Over Time

Abstract This final article in our 12-part series articulating a suite of quality improvement studies completes our report on the Deepening our Understanding of Quality in Australia (DUQuA) program of work. Here, we bring the Supplement’s key findings and contributions together, tying up loose ends. Traversing the DUQuA articles, we first argued the case for the research, conducted so that an in-depth analysis of one country’s health system, completed 5 years after the landmark Deepening our Understanding of Quality Improvement in Europe (DUQuE), was available. We now provide a digest of the learning from each article. Essentially, we have contributed an understanding of quality and safety activities in 32 of the largest acute settings in Australia, developed a series of scales and tools for use within Australia, modifiable for other purposes elsewhere, and provided a platform for future studies of this kind. Our main message is, despite the value of publishing an intense study of quality activities in 32 hospitals in one country, there is no gold standard, one-size-fits-all methodology or guarantee of success in quality improvement activities, whether the initiatives are conducted at departmental, organization-wide or whole-of-systems levels. Notwithstanding this, armed with the tools, scales and lessons from DUQuA, we hope we have provided many more options and opportunities for others going about strengthening their quality improvement activities, but we do not claim to have solved all problems or provided a definitive approach. In our view, quality improvement initiatives are perennially challenging, and progress hard-won. Effective measurement, evaluating progress over time, selecting a useful suite of quality methods and having the persistence to climb the improvement gradient over time, using all the expertise and tools available, is at the core of the work of quality improvement and will continue to be so.

scholarly journals An overview of clinical governance policies, practices and initiatives

2008 ◽  
Vol 32 (1) ◽  
pp. 10 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Joanne F Travaglia
Keyword(s):  
Health Services ◽  
Best Practices ◽  
Continuous Improvement ◽  
Boards Of Directors ◽  
Grey Literature ◽  
Clinical Governance ◽  
Quality And Safety ◽  
Effective Exchange ◽  
And Performance ◽  
Safety Strategy

Objective: To map the emergence of, and define, clinical governance; to discuss current best practices, and to explore the implications of these for boards of directors and executives wishing to promote a clinical governance approach in their health services. Methods: Review and analysis of the published and grey literature on clinical governance from 1966 to 2006. Medline and CINAHL databases, key journals and websites were systematically searched. Results: Central issues were identified in the literature as key to effective clinical governance. These include: ensuring that links are made between health services? clinical and corporate governance; the use of clinical governance to promote quality and safety through a focus on quality assurance and continuous improvement; the creation of clinical governance structures to improve safety and quality and manage risk and performance; the development of strategies to ensure the effective exchange of data, knowledge and expertise; and the sponsoring of a patientcentred approach to service delivery. Conclusions: A comprehensive approach to clinical governance necessarily includes the active participation of boards and executives in sponsoring and promoting clinical governance as a quality and safety strategy. Although this is still a relatively recent development, the signs are promising.

scholarly journals The role of boards in clinical governance: activities and attitudes among members of public health service boards in Victoria

2013 ◽  
Vol 37 (5) ◽  
pp. 682 ◽  
Author(s):  
Marie M. Bismark ◽  
Simon J. Walter ◽  
David M. Studdert
Keyword(s):  
Public Health ◽  
Quality Of Care ◽  
Health Service ◽  
Health Services ◽  
Public Health Service ◽  
Clinical Governance ◽  
Board Members ◽  
Quality And Safety ◽  
Quality Performance

Objectives To determine the nature and extent of governance activities by health service boards in relation to quality and safety of care and to gauge the expertise and perspectives of board members in this area. Methods This study used an online and postal survey of the Board Chair, Quality Committee Chair and two randomly selected members from the boards of all 85 health services in Victoria. Seventy percent (233/332) of members surveyed responded and 96% (82/85) of boards had at least one member respond. Results Most boards had quality performance as a standing item on meeting agendas (79%) and reviewed data on medication errors and hospital-acquired infections at least quarterly (77%). Fewer boards benchmarked their service’s quality performance against external comparators (50%) or offered board members formal training on quality (53%). Eighty-two percent of board members identified quality as a top priority for board oversight, yet members generally considered their boards to be a relatively minor force in shaping the quality of care. There was a positive correlation between the size of health services (total budget, inpatient separations) and their board’s level of engagement in quality-related activities. Ninety percent of board members indicated that additional training in quality and safety would be ‘moderately useful’ or ‘very useful’. Almost every respondent believed the overall quality of care their service delivered was as good as, or better than, the typical Victorian health service. Conclusions Collectively, health service boards are engaged in an impressive range of clinical governance activities. However, the extent of engagement is uneven across boards, certain knowledge deficits are evident and there was wide agreement among board members that further training in quality-related issues would be useful. What is known about the topic? There is an emerging international consensus that effective board leadership is a vital element of high-quality healthcare. In Australia, new National Health Standards require all public health service boards to have a ‘system of governance that actively manages patient safety and quality risks’. What does this paper add? Our survey of all public health service Boards in Victoria found that, overall, boards are engaged in an impressive range of clinical governance activities. However, tensions are evident. First, whereas some boards are strongly engaged in clinical governance, others report relatively little activity. Second, despite 8 in 10 members rating quality as a top board priority, few members regarded boards as influential players in determining it. Third, although members regarded their boards as having strong expertise in quality, there were signs of knowledge limitations, including: near consensus that (additional) training would be useful; unfamiliarity with key national quality documents; and overly optimistic beliefs about quality performance. What are the implications for practitioners? There is scope to improve board expertise in clinical governance through tailored training programs. Better board reporting would help to address the concern of some board members that they are drowning in data yet thirsty for meaningful information. Finally, standardised frameworks for benchmarking internal quality data against external measures would help boards to assess the performance of their own health service and identify opportunities for improvement.

scholarly journals Clinical leadership in paramedic services: a narrative synthesis

2017 ◽  
Vol 22 (4) ◽  
pp. 251-268 ◽  
Author(s):  
Peter O’Meara ◽  
Gary Wingrove ◽  
Michael Nolan
Keyword(s):  
North American ◽  
Systems Approach ◽  
Self Regulation ◽  
Developed Countries ◽  
Clinical Governance ◽  
Shared Responsibility ◽  
Narrative Synthesis ◽  
Quality And Safety ◽  
Clinical Leadership ◽  
Content Type

Purpose In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation. Design/methodology/approach This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications. Findings Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics. Originality/value The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

Supporting and activating clinical governance development in Ireland: sharing our learning

2015 ◽  
Vol 29 (4) ◽  
pp. 455-481 ◽  
Author(s):  
Maureen A. Flynn ◽  
Thora Burgess ◽  
Philip Crowley
Keyword(s):  
Patient Safety ◽  
Clinical Care ◽  
Clinical Governance ◽  
Quality And Safety ◽  
Content Type ◽  
Governance Framework ◽  
Integrative Research ◽  
Action Project ◽  
Action Projects

Purpose – The purpose of this paper is to present a description of the Irish national clinical governance development initiative and an evaluation of the initiative with the purpose of sharing the learning and proposing actions to activate structures and processes for quality and safety. The Quality and Patient Safety Division of the Health Service Executive established the initiative to counterbalance a possible focus on finances during the economic crisis in Ireland and bring attention to the quality of clinical care. Design/methodology/approach – A clinical governance framework for quality in healthcare in Ireland was developed to clearly articulate the fundamentals of clinical governance. The project plan involved three overlapping phases. The first was designing resources for practice; the second testing the implementation of the national resources in practice; and the third phase focused on gathering feedback and learning. Findings – Staff responded positively to the clinical governance framework. At a time when there are a lot of demands (measurement and scrutiny) the health services leads and responds well to focused support as they improve the quality and safety of services. Promoting the use of the term “governance for quality and safety” assisted in gaining an understanding of the more traditional term “clinical governance”. The experience and outcome of the initiative informed the identification of 12 key learning points and a series of recommendations Research limitations/implications – The initial evaluation was conducted at 24 months so at this stage it is not possible to assess the broader impact of the clinical governance framework beyond the action project hospitals. Practical implications – The single most important obligation for any health system is patient safety and improving the quality of care. The easily accessible, practical resources assisted project teams to lead changes in structures and processes within their services. This paper describes the fundamentals of the clinical governance framework which might serve as a guide for more integrative research endeavours on governance for quality and safety. Originality/value – Experience was gained in both the development of national guidance and their practical use in targeted action projects activating structures and processes that are a prerequisite to delivering safe quality services.

Towards a Functional Model of Quality Improvement Collaboratives

2007 ◽  
Vol 51 (11) ◽  
pp. 707-711
Author(s):  
Emily S. Patterson ◽  
Sharon Schweikhart ◽  
Shilo Anders ◽  
Suzanne Brungs ◽  
Marta L. Render
Keyword(s):  
Quality Improvement ◽  
Functional Model ◽  
Healthcare Quality ◽  
Quality And Safety ◽  
Critical Elements ◽  
Quality Improvement Collaboratives ◽  
Support Research

Quality improvement collaboratives (QIC) are widely used for seeking improvements in healthcare quality and safety. Nevertheless, the effectiveness of QICs is variable. In order to support research that identifies critical elements in running a successful collaborative, we fill a conceptual gap by moving towards a functional model of QICs. Specifically, we define how QICs are distinct from traditional quality improvement teams, conceptualize how primary and secondary functions are accomplished in a means-ends framework, and illustrate how the functions are dynamically accomplished in a series of meetings by nested teams within a collaborative. Finally, we discuss distinctions among QICs.

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