Clinical Governance and Risk Management - Essay Example

Name : xxxxxxxxxxx Institution : xxxxxxxxxxx Course : xxxxxxxxxxx Title : Clinical governance and Risk Management Tutor : xxxxxxxxxxx @ 2009 Clinical governance and risk management Introduction Clinical governance can be termed as a system or a set of procedures through which the management of a clinical healthcare centre is accountable for ensuring that there is continuous effectiveness and improvement in the quality of services delivered to the general public. Furthermore, clinical governance entails safeguarding the high standards of delivering care through the establishment of an environment whereby clinical excellence can flourish. Practices of clinical governance revolve around risk management. Basically risk management entails the identification and evaluation of risks in the clinical settings thereafter formulating and executing measures that that are bound to counter the impending danger caused by the risks (Laura & Plebani 2006). Eradicating and minimizing clinical error has over the course of time become a global concern. Recent research has clearly indicated that there have been high rates of medical injuries and deaths that have been brought about as a result of medial errors. The introduction and implementation of appropriate clinical governance and risk management measures is imperative in the clinical practice. Due to the grave nature of the medical field there is need that a lot of factors revolving around clinical governance and risk management should be put into account. Individuals in the clinical field need to be empowered so that they can change and improve in the way that they deliver their services to the general public. It is evident that the implementation of sound clinical governance and risk management practices reduces medical errors thus bringing about efficiency and effectiveness in the clinical practice (Sale 2009). Clinical governance generally entails a context whereby effective risk management practices in the clinical field can be executed, promoted and improved. It is essential that the practices of clinical governance and risk management should not be viewed as a separate or an occasional activity rather these practices should be executed on a daily basis by individuals in the clinical practice. There is also need that that the individuals in the clinical practice should show, multidisciplinary, willingness and diligence in executing the practices of clinical governance and risk management. This essay seeks to provide an incisive and comprehensive outlook on what clinical governance and risk management entails as a clinical specialist. In this essay I will reflect on my emerging role as a specialist in the clinical practice. Moreover, I will give a description of my contribution as a clinical specialist in clinical governance and risk management. Additionally, this essay will illustrate, analyse and critique the practices of clinical governance and risk management in the organization that I offer my services. Literature Review In the modern settings of the clinical practice, clinical governance entails a set of systematic approaches of improving and maintaining the quality of health care in a health system. Clinical governance also encompasses around high standards of healthcare, accountability and responsibility in clinical practice. Furthermore, clinical governance requires dynamic consistency and improvement in the healthcare systems. The concept of clinical governance, involves some parallels of corporate governance. These parallels generally involve certain structures, procedures and systems that are put in place so as to ensure that there is accountability, proper management and efficiency in the delivery of health care services. Nonetheless the concept of clinical governance is only relevant to organizations that deal with healthcare and social care matters. The key elements of clinical governance include, risk management, education, training, clinical audit, openness, clinical effectiveness research and development among many other practices. Risk management is a primary constituent of clinical governance. When addressing the issue of risk management in a healthcare system three factors must be put into consideration. These three factors include the risks that revolve around patients, the practitioners and the organization. The issue of risk management amongst patients generally requires compliance with the set statutory guidelines and regulations in order to reduce risks among patients. Furthermore, reducing risk requires that the alleged health care systems should regularly evaluate and improve the quality of service given to the general public. When addressing the issue of risk management amongst practitioners there is need that clinicians and the entire work force in the healthcare systems should be protected and even immunized from infectious diseases. Additionally, the management of the healthcare system needs to ensure that the environment and the work conditions in the healthcare system do not pose risks to the work force. This will require that the management of the healthcare system is up to date with the crucial aspects of quality assurance (Borodzicz 2005). The issue of risk management in the organization requires consistent efforts that are geared towards ensuring that that the quality of services delivered are essentially up to the set standards this is mainly due to the fact that services that are of poor quality pose a great threat to the organization. Nevertheless, risk management amongst patients, practitioners and the organization at large requires that the management body ascertains that the work force in the healthcare system are competent enough to meet the set standards in the delivery of services. Competency amongst individuals in the work force in the healthcare system can be upheld through introducing and implementing policies that review and evaluate the performance of the individuals and the teams present in the healthcare system. Training and education is an aspect of great essence in clinical governance although it is quite rare that most clinicians should continuously educate themselves or undergo trainings even after qualifications. However, it is vital that clinicians should be subjected under optimum training and education since most of what they were taught becomes outdated over the course of time. Clinical audit is also imperative in the course of clinical governance. This process involves an ardent review of the performance in the healthcare system. This process also entails the refinement of the practices in the clinic in reference to the measurements and results of performance against the set standards. Clinical audit ensures that there is an ongoing process of improving the quality of services delivered to the general public. Clinical governance revolves around clinical effectiveness. Clinical effectiveness is generally a procedure that is geared towards evaluating the extent to which the applied clinical interventions work or the effectiveness of these interventions. The evaluation of these clinical interventions assists in discovering whether these interventions are safe, efficient and worth the inputted costs. Research and development is a fundamental element of clinical governance this is mainly due to the fact that effective professional practice is characterized by profound evidence attained through research. It is therefore important that techniques that promote the research practice amongst clinicians should be accentuated. These techniques include critical evaluation of literature, implementation strategies and project management among many other techniques. The frame work of open discussion and proceedings is also a crucial aspect of clinical governance. Practical Application In my area of practice, I am a clinical specialist who has attained graduate training that has enhanced my clinical expertise in the diagnosis, treatment and the delivery of nursing interventions. In most cases I work with other nurses so as to improve the outcomes of their nursing practices and to promote clinical expertise in the healthcare programs. Generally, I supervise and give guidelines to the nurses in the course of their practice. In the organization that I am attached to, the scope of my practice revolves around, the patient, their families, the nursing work force and the organization’s systems. As a clinical specialist in this organization my primary goal lies in ensuring that there is continuous improvement and enhancement in the nursing practice and patient outcomes. As a clinical specialist in this organization, I am accountable in formulating ethical decisions that pertain to the nursing practice. This process involves negotiating, influencing and intervening in ethical dilemmas. I am to a large extent responsible for making decisions that revolve around the allocation of healthcare resources. Furthermore, I am responsible for directing and coordinating patient care. I also work to ensure that each patient who visits our healthcare system has access to the appropriate care and medication. As a far as professional and clinical leadership is concerned, I am responsible for introducing and implementing changes and innovations in the healthcare programs. Additionally, my role as professional and clinical leader revolves around troubleshooting and risk management. Troubleshooting entails solving the day to day problems in the healthcare system that are within the scope of my profession. In my area of practice, my emerging role entails carrying out and coordinating research. These roles involve using and interpreting research. Furthermore, these roles entail collaborating with other principles in the research work and evaluating the research practices. As a clinical specialist I am responsible for directing clinical practices in the organization. This role also entails evaluating the outcomes of the nursing practice and implementing strategies that are bound to improve the standards of the services delivered to the general public. Moreover, in the organization I played the role of providing expert coaching to the work force. Expert coaching in the clinical field entails giving guidance and modeling clinical expertise in the nursing practices. In the course of expert coaching, nurses learn and integrate new intervention and evidence into their clinical practice. As a clinical specialist in this organization I am accountable for enhancening collaboration in the healthcare system. This role centers on team building among the various multidisciplinary bodies in the healthcare system. Additionally, my area of practice entails consultation as a method of risk management and clinical governance. Consultation requires collaborative approaches, the reviewing of the available options and the execution of the suggested changes(Lugon, & Secker-Walker 2001). Analysis and critique of the clinical governance and risk management practices in the organization In this organization clinical governance and risk management practices are exercised in various ways. For instance, the organization has an audit committee whose main functions revolve around reviewing the maintenance and establishment of the effectiveness of the risk management and internal control systems. Furthermore, the audit committee evaluates the organization’s compliance to the set standards in the healthcare system. The functions of the audit committee have over the course of time played a great role in evaluating whether the existing systems and practices of clinical governance and risk management are effective. However, the functions of the audit committee are somewhat limited as far as clinical governance and risk management practices are concerned. This is mainly because the evaluation and audit of some aspects in the clinical practice are essentially difficult to establish. For example when auditing or evaluating the cause of death amongst patients, it is difficult to ascertain whether the cause of their alleged death can be attributed to the performance of the clinical personnel or other natural factors. In this organization, training is used as method of enhancing clinical practices. The management organizes monthly trainings that are geared towards the enhancement of skills amongst the clinical personnel. Moreover, these training exercises provide the appropriate platform whereby the clinical personnel can be equipped. In the course of these trainings, the clinical personnel find the opportunity to air their questions and concern in their clinical practice. The training experts in turn address these questions and concerns thus heightening the understanding of the clinical personnel in their clinical practice. Additionally, these trainings keep the clinical personnel current with the current trends of clinical practice. Generally these training are essentially beneficial to the work force in a healthcare system since they heighten the knowledge of the clinical personnel, they equip the work force with more skills. Furthermore these trainings provide a platform whereby crucial issues in the nursing practice can be addressed. However, it is worth noting that evaluating training effectiveness is key especially when determining the effectiveness and relevancy of the conducted training (McSherry & Tingle 2001). The use of training as a stratagem for clinical governance and risk governmence in the organization has some limitations. For instance, there is bound to be generalizability in the course of the training. Most of the trainings conducted tend to generalize the various concepts involved in the nursing practice. Consequently, the specific needs of the different factions of the clinical personnel are not addressed during these trainings. Moreover, the conducted training has some longitudinal effects. The training conducted in this organization does not necessarily bring about results that predict or modify behavior in the clinical practice as far as clinical governance and risk management is concerned. The organization has a framework of policies that encompass around, the roles, accountability and responsibility of the various clinical personnel in the healthcare system. These policies have stipulated the roles of the various factions or departments in the healthcare system. The set of policies also designate the area of accountability for each department. For example, in the settings of the organization, according to the set policies, the heads of department have the role of efficiently managing and coordinating the overall practices in that department. On the other hand, according to the set policies, the roles of the nurse leaders include, coordinating the activities executed by the regular nurses and ensuring that the set protocols are followed to the later. Moreover, according to the frame work of policies in this organization the nurse leaders are accountable to the head of department (Sale 2009). The implementation of these policies greatly assists in bringing orderliness and a sense of direction in the clinical practice. Furthermore, these policies enhance responsibility and accountability in the clinical practice. Since they help in the delegation of duties to the clinical personnel. Consequently, clinical governance is made easier through these policies. In the face of risks in the healthcare settings these policies enable the work force to know their role and their scope of involvement during the management of risks. Nevertheless, the execution of these policies limits the performance of the work force in the settings of the organization as far the practices of clinical governance and risk management are concerned. This is mainly because they give no room for partnership, creativity or innovativeness. The policies in this organization are somewhat rigid such that they do not allow the involvement of other parties in the course of clinical governance and risk management. Additionally, these policies have strict regulations on the duties and roles of each clinical personnel in regard to the practices of clinical governance and risk management. These regulations do not provide a base whereby new talent and skills in the clinical practice can be exposed and exploited. In this organization strategies of risk management revolve around, the identification of the existing risks, the evaluation of those risks, thereafter strategies of preventing or managing these risks are put in place. The clinical personnel in this organization strive to improve and maintain the quality of healthcare services provided to the general public. However, it is imperative that the organization explicitly demonstrates that its work force is competent enough to counter the needs of the patients, their families and other involved parties. The fact that the organization has fulfilled and met the standards of the medical practices does not necessarily imply that it is currently fulfilling the existing needs of the patient and clinical personnel sorority in regard to the existing risk management practices (Alexander& Sheedy 2005). Clinical governance in this organization has received the much needed attention. The organization has put in place mechanisms that are geared towards ensuring that there is a consistency and continuous improvement in the delivery of health care services to the public. Adequate funding to the organization has enabled the actualization of this goal to a certain extent. Nonetheless, the organizations internal system needs to be modified or even so improved (Royal College of Physicians1999). Contributions to the organization’s clinical governance and risk management practices As a clinical specialist in this organization, I endeavor to contribute to the organization’s clinical governance and risk management practices. Foremost, the efforts I am bound to execute will revolve around human resource strategies. This is due to the fact that, the human resource in this case the clinical personnel are the most important asset to the organization. Since they determine the general performance of the organization. Therefore, it is imperative that a lot of emphasis should be directed towards motivating the clinical personnel. As a clinical specialist I will implement reinforcement strategies that center on motivating the clinical personnel. For instance, the reinforcement strategies that I will use include, commending the work force and rewarding them for work well done. By motivating the clinical personnel performance in reference to the practices of clinical governance and risk management is bound to improve (Lugon, & Secker-Walker 2001). Additionally, as a clinical specialist in this organization, I intend to enhance team work amongst the clinical personnel. This is mainly because, team work promotes innovation and creativity. It brings about quality end results and better services. It also establishes better flexibility and adaptability in the organization. By carrying out team building activities such as staff retreats and improving communication links. Furthermore, team work can be enhanced by conducting trainings that address team issues. The enhancement of team work amongst the clinical personnel will ensure that practices of clinical governance and risk management are continuously being improved and that the health services delivered to the general public are of high standards. Modern technology has proved to be essentially beneficial in the clinical practice. Over the course of time the traditional methods of operation in the healthcare systems have proved to be deficient and to some extent ineffective in the delivery of healthcare services. Nevertheless, the application of modern technology in the routine operations of the clinical practice can bring about effectiveness and efficiency in service delivery. Furthermore, the integration of modern technology in the clinical practice makes the delivery of healthcare services to be fast. It also diminishes the chances of errors in medical area. As a clinical specialist in this organization, I endeavor to advocate for the use of modern technology especially in the area of clinical governance and risk management. Advocating for the use of modern technology will require that the work force receives optimum education on the advantages and ways of applying modern technology in the clinical practice. (Hamric & Spross 2005). Evidently, the practices that revolve around clinical governance and risk management are intricate and they demand a lot of effort on the part of the clinical personnel in a healthcare system. In some instances the work force can be overwhelmed due to the nature of the presented challenges or risks. In such cases it vital that partnership or consultation arrangements are implemented. In this organization my role as a clinical specialist will be to ensure that in the face difficulties in the in the area of clinical governance and risk management partnership links from other professionals or other corporate bodies can chip in and salvage the situation. An example of how partnership can be promoted in the healthcare system through involvement and active networking. Expertise training is also essential in the process of improving clinical governance and risk management. Although training has some longitudinal effects and be termed as a general, if conducted in the appropriate it can bring about excellent results in the area of clinical governance and risk management. As a clinical specialist in this organization, I intend on introducing training that addresses the specific needs of the different lines of work in the clinical practice. Moreover, I endeavor to ensure that the conducted training is done by professionals in the clinical practice. Furthermore, I intend on contributing to the practices of clinical governance and risk management by introducing and implementing effective clinical audit processes that will ensure that the organization performance is comprehensively evaluated so that effective service delivery outcomes are actualized (Oyebode& Parry 1999). Conclusion Clinical governance refers to a system through which the administrative body of a clinical healthcare centre ensures that there is continuous efficiency and improvement in the quality of services delivered to the general public. Risk management is a principal element of clinical governance. The introduction and implementation of appropriate clinical governance and risk management practices is vital in the clinical practice since these practices minimize the occurrence of medical errors. The fundamental factors of clinical governance include, risk management, education, training, clinical audit, openness, clinical effectiveness research and development among many other practices. As a clinical specialist in my area of practice, my role entails formulating ethical decisions, coordinating research and training among many other roles. In the organization I work in clinical governance and risk management practices are exercised in various ways. For example, there exists an audit committee which evaluates the organization’s compliance to the set standards in the healthcare system. Training is used in the organization as method of enhancing clinical practices. Furthermore, in this organization strategies of risk management involve, the identification of the existing risks, the evaluation of those risks, thereafter strategies of preventing or managing these risks are put in place. Evidently, these practices have proved to be somewhat limiting. Therefore, as a clinical specialist in this organization, I intend to implement reinforcement strategies that center on motivating the clinical personnel. I also endeavor to advocate for the use of modern technology in the routine operations so as to increase efficiency in the delivery of services. Bibliography Laura, M & Plebani, M, 2006, Clinical Governance: from clinical risk management to continuous quality improvement, Clinical chemistry and laboratory medicine journal, vol. 44, no pp. 694-698. Sale, D, 2009, Understanding Clinical Governance and Quality Assurance, Macmillan Publishers, New York. Borodzicz, E, 2005, Risk, Crisis and Security Management, Wiley Publishers, New York. Alexander, C& Sheedy, E, 2005, The Professional Risk Managers' Handbook: A Comprehensive Guide to Current Theory and Best Practices. PRMIA Publications. New York. Hamric, J & Spross, A (2005), Advanced practice nursing: An integrative approach. Elsevier: St. Louis. Agran, D, 1993, Experience-based training and development: directory of programs, Association of Experiential Education, Boulder. Royal College of Physicians, 1999, Physicians Maintaining Good Medical Practice: Clinical Governance and Self-Regulation. Royal College of Physicians, London. Oyebode, F, & Parry, L, 1999, Clinical governance in practice, Retrieved on October 8 2009 < http://apt.rcpsych.org/cgi/reprint/5/6/399.pdf> Lugon, M & Secker-Walker, J, 2001, Advancing clinical governance, RSM Press, New York. McSherry, R & Tingle, J, 2001, Clinical governance: a guide to implementation for healthcare professionals, Wiley Blackwell, New York. Read More