Clinical Governance ensures that patients are the main focus and priority in hospices, and that each patient gets safe, high quality care from everyone involved in looking after them. Clinical governance therefore underpins the standards against which the Healthcare Commission and the Care and Social Services Inspectorate of Wales (CSSIW) inspects and regulates voluntary hospices.
Clinical governance was formally adopted in the NHS in 1999, and has been recommended for implementation in all healthcare organisations within the UK.
“Governance is a framework through which 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.”
Put more simply, clinical governance ensures safe, high quality care from all involved in the patient’s journey and ensures that patients are the main focus and priority.
Clinical governance therefore underpins the standards against which the Healthcare Commission inspects and regulates voluntary hospices.
The National Council for Palliative Care endorses and supports clinical governance. In ‘Raising the Standard, Clinical Governance for Voluntary Hospices 2000’ it describes clinical governance as:
“An internal framework through which voluntary sector providers of hospice and specialist palliative care demonstrate accountability for and ensure continuous improvement in the quality of their services for patients and those who care for them and the safeguarding of high standards of care by creating an environment in which excellence in clinical care will flourish.”
Key components of clinical governance include:
- Clear lines of accountability for the overall quality of clinical care
- Clinical effectiveness, using practice based on evidence
- A programme of quality improvement activity
- Clinical risk management systems
- Systems for identifying and dealing with poor performance
- Systems for professional development
- Audit of care and outcomes.
It is a concept which combines all elements of quality to create an integrated approach to delivering quality care. The key developments are an accountability framework for clinical governance, a strategy to implement and feedback systems and reports on activity which keeps the senior management team and board informed.
Ten key elements have been identified to achieve quality improvements:
- Clinical leadership
- Clinical performance
- Clinical audit
- Clinical risk management
- Continuing healthcare needs assessment
- Changing practice through evidence, using research findings
- Continuing education
- Service users’ experiences
- Clear accountability