Clinical Governance Flashcards
what is clinical governance? 3 reasons
system through which NHS organisations are accountable for:
- continuously improving quality of services
- creating an environment in which clinical excellence will flourish
6 pillars of clinical governance +1
-clinical effectiveness
-research and development
-openness
-risk management
-education and training
-clinical audit
using information and IT
4 aspects used by WHO
- professional performance (technical quality)
- resource use (eg money, efficiency)
- risk management (risk of injury or illness)
- pt satisfaction
3 aims of clinical governance
-consolidate
-codify
-universalise
policies and approaches to create organisation in which final accountability rests with a body or individual
what paper defined these aims of clinical governance
NHS White Paper 1999
example of why clinical governance has been put in place
TAMOXIFEN: drug used for some breast cancers. only available in some counties
–>clinical governance unified standards
3 objectives that need to be met by governments to provide good clinical governance
- improve continually the overall standards
- reduce unacceptable variations
- ensure best resources so patients receive greatest benefits
3 things care provided should be
- appropriate to peoples needs
- effective - drawing on on best available clinical evidence
- efficient- economic, maximises health gain for population
what 3 things is development of National Guidance based on?
- reliable evidence of clinical cost effectiveness
- experience of health professionals and managers
- values and wishes of patients
why are there problems with NHS research and development strategy?
evidence is rapidly expanding. have to decide between contradictory evidence and lack of evidence
–>blame could often be placed with clinician
what company is meant to solve NHS Research and development issues and how? 6
National Institute for Clinical Evidence (NICE):
- identify new and existing health interventions
- collect evidence
- advise on best practice
- appraise new health interventions
- disseminate
- implement
- monitor
- how they are implemented
- how the
how strict are NICE guidelines? explain, eg
they are only GUIDELINES –> can go outside them. eg guidance is not to extract mesio-angled wisdom teeth unless proof of infection or caries, but waiting for this proof destroys the 2nd molar
purpose of national service frameworks
set out what patients can expect from NHS, eg waiting time limits for cancer treatments, centralisation of rare procedures eg cleft palate to ensure high standard
what does clinical governance encourage in a working environment
- open and participative –> no blame on individuals
- ideas and good practice are shared
- education and research are valued
why does clinical governance encourage these things in working environments?
5:
- modernise and strengthen professional self-regulation
- build on principle of performance review
- strengthen existing systems of quality control
- use evidence based practice
- learn lessons of poor performance (assess and minimise risk of untoward events, investigate problems as they arise)
