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Clinical Governance

Clinical Governance. Dr Varsha Mulik Consultant O&G Tameside General Hospital. Definition .

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Clinical Governance

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  1. Clinical Governance Dr Varsha Mulik Consultant O&G Tameside General Hospital

  2. Definition • A framework through which NHS organisations are accountable for continuously 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. What is it? • Professional & service development • Maximise quality:EBM,R&D • CPD to meet learning needs of individual as well as NHS • CPD is not what you want to do, but what you need to do • Minimise inequalities :Healthcare,people’s health • Audit & evaluation • Risk management

  4. Individual personal development plan Departmental developmental plan Trust business plan

  5. Main areas of service development • Recent or expected NSFs • Local health improvement programme • Local priorities • Current and anticipated changes in service delivery e.g. integrated teams • Generic learning e.g. communication, team building • Learning culture

  6. Learning culture • Appraisal • Feed back -- 360 degrees • Knowledge & Skills • Sustained quality improvement culture • Reflective practice

  7. Patient & public involvement • Individual patients about their own care • Range & quality of health services on offer • Planning & organising health service developments • Focus groups, special interest patient groups, general public opinion,in-house systems like suggestion boxes, complaints

  8. Risk management • Good record keeping • Risk assessment • Risk management of clinical conditions: incident reporting • Controlling risk factors • ‘No blame’ culture

  9. Audit • Provides the mechanisms for reviewing the quality of everyday care provided to patients with common conditions • Builds on a long history of doctors, nurses and other healthcare professionals reviewing case notes and seeking ways to serve their patients better. • Addresses quality issues systematically and explicitly, providing reliable information. • Can confirm the quality of clinical services and highlight the need for improvement

  10. Definition of clinical audit Quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria.

  11. Failures of clinical audit • Poor design • Poor data collection • Lack of senior support & involvement • Poorly managed, inadequately carried out, or both • No change in practice

  12. Bristol Royal Infirmary recommendations DoH 2001 • The process of clinical audit, should be at the core of a system of local monitoring of performance. • Clinical audit must be fully supported by trusts. They should ensure that healthcare professionals have access to the necessary time, facilities, advice, and expertise in order to conduct audit effectively. All trusts should have a central clinical audit office that coordinates audit activity, provides advice and support for the audit process, and brings together the results of audit for the trust as a whole. • Clinical audit should be compulsory for all healthcare professionals providing clinical care and the requirement to participate in it should be included as part of the contract of employment.

  13. Audit cycle Stage one Preparing for audit Stage two Selecting Criteria Stage three Measuring Performance Creating environment Stage four Making Improvements Using methods Stage five Sustaining Improvements

  14. References • Department of Health. The New NHS: Modern, Dependable. London: The Stationery Office, 1997. • Department of Health. A First Class Service. Quality in the New NHS. London: Department of Health, 1998. • Department of Health. The NHS Plan: A Plan for Investment – A Plan for Reform. London: The Stationery Office, 2000. • Department of Health. Learning from Bristol: the Report of the Public Inquiry into Children’s Heart Surgery at the Bristol Royal Infirmary 1984–1995. Command paper CM 5207. London: The Stationery Office, 2001. • Grimes K. Using patients’ views to improve a health care service. Journal of Clinical Excellence 2000; 2: 99–102. • Healthcare Quality Quest. Clinical Audit Manual: Using Clinical Audit to Improve Clinical Effectiveness. Romsey: Healthcare Quality Quest, 1999

  15. Thank You

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