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Principles to govern clinical governance
1Wirral Health Authority, St Catherine's Hospital, Birkenhead, UK.
Journal of Evaluation in Clinical Practice
|January 2, 2001
Summary
Clinical governance, a National Health Service (NHS) initiative, aims to improve care through evidence-based policies. This paper argues for embracing it willingly but not rigidly, proposing principles to maximize benefits and manage conflicts with clinical freedom.
Area of Science:
- Healthcare Management
- Clinical Policy
- Medical Ethics
Background:
- Clinical governance is an NHS initiative using guidelines and frameworks to enforce evidence-based clinical policies.
- Its implementation has complex implications for healthcare delivery and practice.
Purpose of the Study:
- To analyze clinical governance as a method for promoting specific types of excellent practice.
- To differentiate between non-compliance and bad practice, advocating for separate management strategies.
- To propose principles for maximizing clinical governance benefits and minimizing harms.
Main Methods:
- Conceptual analysis of clinical governance principles and their implications.
- Development and argumentation for a set of principles to govern clinical governance and manage bad practice.
- Ethical reasoning regarding clinical freedom and patient choice within governance frameworks.
Main Results:
- Clinical governance promotes a particular form of excellent practice; non-compliance does not inherently signify bad practice.
- Separate strategies are necessary for addressing and managing bad practice.
- Principles are proposed to optimize clinical governance and mitigate potential negative consequences.
Conclusions:
- Doctors should embrace clinical governance voluntarily.
- The NHS should avoid rigid enforcement of clinical governance.
- Adherence to ethical principles is crucial for managing conflicts arising from restricted clinical freedom and patient choice.