Trenti Tommaso, Canali Claudia, Scognamiglio Annamaria
Patologia Clinica, Tossicologia e Diagnostica Avanzata, Ospedale Nuovo Sant'Agostino Estense, Dipartimento di Patologia Clinica, Modena, Italy.
Clin Chem Lab Med. 2006;44(6):724-32. doi: 10.1515/CCLM.2006.130.
Clinical Governance is described as "a framework through which the NHS organisations are accountable to continue to improve the quality of the service and safeguarding high standards of care by creating an environment in which excellence in clinical care would flourish"; it is aimed to ensure continuous improvement in the overall standard of clinical care, ensuring that clinical decisions are based on the most up-to-date evidence in terms of effectiveness.
If Clinical Governance is a framework through which NHS organisations are accountable to continuously improve the quality of their services and safeguarding high standards of care, Clinical Effectiveness is a vital part of Clinical Governance. Clinical Effectiveness is a term that refers to measuring and monitoring the quality of care, and comprises various activities, including: Evidence-Based Practice, Research and Development, Clinical Audit, Clinical Guidelines, Integrated Care Pathways, and Total Quality Management.
The application of evidence-based medicine (EBM) in laboratory medicine or evidence-based laboratory medicine (EBLM) aims to advance clinical diagnosis by researching and spreading new knowledge, combining methods from clinical epidemiology, statistics and social science with the traditional pathophysiological molecular approach. EBLM, by evaluating the role of diagnostic investigations in the clinical decision-making process, can help in translating the results of good quality research into everyday practice.
If Clinical Governance is a framework through which organisations are accountable to improve the quality of care, health professionals should identify high quality standards, and systematically and rigorously monitor against them the process and outcomes that represent the diagnostic process. Within such a policy framework, practice guidelines are expected to play a major role, providing the basis to access the quality of care and guidance where clinical practice is found not in line with professional standards.
临床治理被描述为“一个框架，通过该框架，英国国家医疗服务体系（NHS）组织有责任通过营造一个能使卓越临床护理蓬勃发展的环境，持续提高服务质量并维护高标准的护理”；其目的是确保临床护理的整体标准持续提升，确保临床决策基于有效性方面的最新证据。
如果临床治理是一个使NHS组织有责任持续提高其服务质量并维护高标准护理的框架，那么临床有效性就是临床治理的重要组成部分。临床有效性是一个指衡量和监测护理质量的术语，包括各种活动，如：循证实践、研究与开发、临床审计、临床指南、综合护理路径和全面质量管理。
循证医学（EBM）在检验医学中的应用或循证检验医学（EBLM）旨在通过研究和传播新知识来推进临床诊断，将临床流行病学、统计学和社会科学的方法与传统病理生理分子方法相结合。EBLM通过评估诊断检查在临床决策过程中的作用，有助于将高质量研究的结果转化为日常实践。
如果临床治理是一个组织有责任提高护理质量的框架，那么卫生专业人员应确定高质量标准，并系统且严格地对照这些标准监测代表诊断过程的过程和结果。在这样的政策框架内，实践指南有望发挥主要作用，为评估护理质量以及在临床实践不符合专业标准时提供指导依据。
