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ePaper created 2015-02-10, 15:02:41 | version 1.33.01
Dr Kashif Hafeez UK While accountability and im- provementhavebeeneminentin health care systems for quite some time, there is probably no other time in history when the relevance and importance of thesehavebeenmoreadvocated. Learning from our shortcomings and improving our health care system towards better patient care is the goal of clinical gover- nance. I refer to it as the democ- racy of the health care system, in which all members of the health care team have the right to bring about positive changes. Accountability and learning from self-criticism forms the basis of clinical governance, which pro- vides the framework for taking all the steps necessary to make the system more patient friendly. It is a cyclical process that once estab- lished can help to identify the deci- sivefactorsforthequalityofpatient care. When asked by one of my trainees when the mechanisms of clinical governance ensue in everyday practice, my answer was, “In a patient-centred practice it never stops”. It starts as early as the patient first contacts a practice or a hospital and encompasses the entire health care scenario, start- ing with welcoming and managing a new patient, ensuring his or her safetyonourpremisesandadvising himorheraboutallaspectsoftreat- ment.Thiscombinationisallabout our transparency to the outside world, ensuring that arbiters and our patients can be certain of our quality of care. Moresimplyput,clinicalgover- nanceistheumbrellaunderwhich we can provide the best care possi- bleforourpatients.Itisastructural framework that incorporates all pillars of the health care system. There are channels for the health care team, management and pa- tientsalike.Particularlyforthelast, clinical governance provides an environment free from potential hazards. In addition, patients are givenavoiceinthesystemthrough patient feedback, ensuring that if they draw attention to any wrong- doing, lessons are learnt and such mistakes are not repeated. For our staff and team mem- bers, clinical governance ensures that they will be inducted into the systemeffectivelyinthebeginning andbeapartofthatsystemthrough organisational meetings and their annual appraisals throughout their whole career. This way, they will have the best opportunity to improve their skills and advance their professional development. Moreover, this allows them to bet- ter judge their clinical effective- ness and communication skills. Sincetrainingandcareerdevel- opmentareintegralpartsofclinical governance, it helps the clinicians toidentifytheirlearningneedsand plan their continued professional development accordingly. Contin- uinginthisloop,theyareabletode- velop improved awareness about the safety of their work environ- ment,asriskmanagementisoneof the basic pillars of clinical gover- nance. Through research and de- velopment opportunities, they can alsolearnnewskillsandtreatment protocols. Clinicalgovernanceisthegirdle of an organisation in a health care system: it encompasses all aspects of improved patient care and keeps all involved units in the loop. The managementofanorganisationcan monitorthequalityofcareprovided by it. It can also rate the clinical ef- fectiveness of a particular specialty or clinician. With patient feedback, it can furthermore identify any shortcomings in the system. It will compel the organisation to strive for the professional development of its employees, safeguarding the clinician’s right to develop profes- sionally. The impartiality of the system opens the organisation to scrutinyandmaintainstheabsolute systemofchecksandbalances. Auditisanindispensablepartof clinicalgovernance,asitallowsthe system to self-analyse and induce changes,ifneeded,thatis,wemake improvements and then re-audit. Oncethiscyclehasbeeninitiated,it will become a continuous process of reanalysis and improvement. The prime feature of this system is that the whole process is self-sus- tainable once the system has been implemented. The checks and balances in the system will keep it going and evolving. The process of clinical gover- nance is quite well established in the Western world, but it is time that this essential system of health care delivery become established in developing eco - nomies. After all, it is all about the patients: it is to ensure their continuedgoodcarethatwestudy intenselyandpursueprofessional development. DT (DTI/PhotoMinervaStudio) DENTALTRIBUNE Asia Pacific Edition No. 1+2/2015 Opinion 5 AD Clinical governance— A system for better health care “...it is time that this essential system of health care delivery become established in developing economies.” DrKashifHafeez is currently in private practice in Carterton in the UK. He can be contacted at hafeezkashif@ hotmail.com. Contact Info DTAP0115_05_Hafeez 09.02.15 10:56 Seite 1 DTAP0115_05_Hafeez 09.02.1510:56 Seite 1