Freedman Danielle B
Department of Chemical Pathology, Luton & Dunstable Hospital NHS Trust, Bedfordshire, Luton, UK.
Clin Chim Acta. 2002 May 21;319(2):133-41. doi: 10.1016/s0009-8981(02)00034-7.
Clinical governance has, for the first time, placed the quality of healthcare as a direct responsibility of the Chief Executive and therefore the board of all NHS Trusts (Hospital), community providers and primary care trusts (general practitioners). The foundation for clinical governance was set out in the Department of Health Publication 'A first class service-quality in the new NHS' [Department Of Health, A First Class Service: Quality in the New NHS, London, HMSO, 1998]. Much of this had been precipitated by the Bristol cardiac surgery case and other series of medical disasters in the UK relating to cervical screening, breast screening, psychiatric care and pathological misdiagnoses. This new responsibility of clinical governance involves guaranteeing quality through a number of processes, many of which are currently in use and should be familiar to any clinician or manager. They include clinical effectiveness and optimisation of clinical care, clinical risk management, learning from complaints, professional development, good quality clinical data systems and involvement of patients and carers. This duty is equal to the other statutory responsibilities of NHS organisations, which are of financial probity, accountability and ensuring value for public money on behalf of the taxpayer.
临床治理首次将医疗保健质量视为首席执行官的直接责任，因此也是所有国民保健服务信托机构（医院）、社区医疗服务提供者以及基层医疗信托机构（全科医生）董事会的直接责任。临床治理的基础在卫生部出版物《一流服务——新国民保健服务体系中的质量》（卫生部，《一流服务：新国民保健服务体系中的质量》，伦敦，皇家文书局，1998年）中有所阐述。这在很大程度上是由布里斯托尔心脏手术事件以及英国其他一系列与宫颈筛查、乳房筛查、精神科护理和病理误诊相关的医疗灾难所引发的。临床治理的这项新职责涉及通过一系列流程来保证质量，其中许多流程目前正在使用，并且任何临床医生或管理人员都应该熟悉。这些流程包括临床疗效和临床护理优化、临床风险管理、从投诉中吸取教训、专业发展、高质量临床数据系统以及患者和护理人员的参与。这项职责与国民保健服务机构的其他法定义务同等重要，这些义务包括财务诚信、问责制以及代表纳税人确保资金的使用价值。
