clinical governance

1. WHY CLINICAL GOVERNANCE
IS AN IMPORTANT ASPECT OF
PATIENT CARE

2. CLINICAL GOVERNANCE
• Systematic approach to maintain and improve the quality of patient care within
the National Health Service (NHS)
• Bristol Heart Scandal (1995)
• A framework 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.

3. “clinical governance is a way of making sure that everyone who passes through health
system is well cared for”
Or
System that enable staff to work in the best possible way
+
Staff performing to the highest possible standards

4. MAJOR COMPONENTS
• Clear national standards
• Mechanisms for ensuring local delivery of these standards
• Mechanisms for monitoring the delivery of these standards

5. Monitor standards
Apply standards
Identify standards
Clinical audit
Manpower planning
Evidence-based medicine
National inquiries
Complaints
Monitoring and evaluation
Whistle-blowing
Continuing professional
development and lifelong
learning
Job plan
Risk management
Clinical standard
Research and
development

7. 1. CLINICAL AUDIT
• Systematic, critical analysis of the quality of medical care to help to provide
reassurance that the best quality of service is being achieved, having regard to the
available resources.
• Clinical audit is a way that doctors, nurses and other healthcare professionals can
measure the quality of the care they offer.
• It’s a tool, not a goal.

8. 2. EDUCATION AND TRAINING
• Providing appropriate support available to enable staff to be competent in doing
their jobs and to develop their skills so that they are up to date.
 Attending courses and conferences (CPD)
 Taking relevant exams
 Regular assessment, designed to ensure that training is appropriate
 Appraisals

9. 3. CLINICAL EFFECTIVENESS
• Clinical effectiveness is a measure of the extent to which a particular intervention
works.
• The measure on its own is useful, but decisions are enhanced by considering
additional factors, such as whether the intervention is appropriate and whether it
represents value for money.

10. 4. RESEARCH AND DEVELOPMENT
• This forms the basis for evidence-based medicine.
• The NHS Research and Development strategy was launched in 1991 to develop a
knowledge-based NHS in which decisions (clinical, policy and managerial ) would have a
sound base.
• 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.

11. 5. OPENNESS
• Processes which are open to public scrutiny, while respecting individual patient and
practitioner confidentiality, and which can be justified openly, are an essential part
of quality assurance.
• Open proceedings and discussion about clinical governance issues should be a
feature of the framework.

12. 6. RISK MANAGEMENT
• Risk management is about minimising risks to patients 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

13. WHY DO WE NEED CLINICAL
GOVERNANCE
• Provides support to ensure safe and high-quality care
• Holds health care workers accountable for their actions
• Provides guidelines for upkeep of clinical skills and competencies
• Develops and maintains policies and procedures
• Assists in maintaining risk management

14. BENEFITS OF CLINICAL GOVERNANCE
• Ensures patients are safe and risks are managed.
• Improves treatment outcome.
• More efficient service
• More effective service
• Better patient satisfaction

15. CLINICAL GOVERNANCE HELPS
PREVENT INCIDENTS

16. Minimising The Risk
Adverse Events
Use of safety and quality framework
Medication Errors
Uncontrolled Pain
Puts safety and quality systems in
place
Failure to deliver safe and quality
care in a timely manner
Continued reviews on use to ensure
patients receive best care
Accidents such as falls and pressure
sores

17. With Clinical Governance
Without Clinical Governance
Quality and safety culture
Quality and safety are not important
Learning culture
Blaming culture
Transparency culture
Secrecy culture
Standart procedures and protocol
No standart procedures and protocol
Audit system
No checking system
Performance monitoring
Performance not monitored
Patient experience is essential
Less emphasis on patient experience
SUMMARY