Clinical Governance

Question 1

What is clinical governance?

Answer 1

Definition – “A system through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish” (Scally and Donaldson, 1998).

Clinical governance is a systematic approach to maintaining and improving the quality of patient care within a health system. It applies to health and social care organisations and applies equally to both the public and private sectors.

Question 2

What are the three key attributes in clinical governance?

Answer 2

1. Recognisably high standards of care.
2. Transparent responsibility and accountability for those standards.
3. Constant dynamic of improvement.

Question 3

What are the components of clinical governance?

Answer 3

• Clinical audit – review of clinical performance, refining clinical practice as a result and then measuring performance against agreed standards.
• Clinical effectiveness – a measure of the extent to which a particular intervention works.
• Education and training – continuing professional development (CPD).
• Risk management – risks to patients, practitioners and the organisation need to be considered and balanced.
• Openness – processes which are open to public scrutiny, while respecting individual patients and practitioner confidentiality, and which can be openly justified, are an essential part of quality assurance.
• Research and development – techniques such as critical appraisal of the literature, project management and the development of guidelines, protocols and implementation strategies are all tools for promoting the implementation of research practice.
• Clinical information and information technology – committed to the development and use of information to improve care and service users’ experience.
• Patient and public involvement – services should be seamless and patient centred.
• Staffing and staff management – committed to the management and direction of staff.

Question 4

What does clinical governance mean in a genetics laboratory?

Answer 4

As well as achieving clinical governance through individual trust boards, UKGTN members are expected to work within specific guidelines for genetics from professional and patient organisations, specifically the BSGM and Genetic Alliance Group. This includes clinical audit, training (including CPD), accreditation, risk management, user involvement and a patient-centred view of quality standards.

Question 5

What is risk management and how can risks be minimised?

Answer 5

Risk is defined as the potential that a chosen action, inaction or activity will lead to an undesirable outcome.
Risk management is about minimizing these risks

By:
 Identifying what can and does go wrong during care
 Understanding the factors that influence this
 Learning lessons from any adverse events
 Ensuring action is taken to prevent recurrence
 Putting systems in place to reduce risks

Question 6

What are the different types of incidents?

Answer 6

Adverse incident reporting allows refinement/redesign of processes based on actual experience. There are several categories listed below:
 Adverse Incident - When an event occurs that causes harm to any person or damage to or loss of any property or assets of the Trust or any individual and may damage the reputation of the Trust.
 Patient Safety Incident - Any unintended or unexpected incident(s) that could have or did lead to harm for one or more persons receiving NHS funded healthcare.
 ‘No Harm’ Incident - Any unexpected or unintended incident which ran to completion but no harm, damage or loss occurred.
 ‘Prevented’ Incident - Any incident that had the potential to cause harm but was prevented from occurring, resulting in no harm, damage or loss.