Lecture 1 - Clinical Governance Introduction

Question 1

What did W.E. Deming say about process mapping?

W.E. Deming 1993 - William Edwards Deming (1900-1993) is widely acknowledged as the leading management thinker in the field of quality. He was a statistician and business consultant whose methods helped hasten Japan’s recovery after the Second World War and beyond. He derived the first philosophy and method that allowed individuals and organisations to plan and continually improve themselves, their relationships, processes, products and services. His philosophy is one of cooperation and continual improvement; it avoids blame and redefines mistakes as opportunities for improvement.

Answer 1

Who said “The first step is to draw a flow diagram. Then everyone understands what his job is. If people do not see the process they cannot improve it”

ie they can be used as quality improvement tool to improve processes once people are clear on the process.

Question 2

What are the features of Clinical Governance (components)

Answer 2

1. Risk Management (protect patients, staff and organisation)
2. Education and Training (continuous)
3. Clinical Audit
4. Clinical Effectiveness
5. Research and Development
6. Openness

Question 3

How can outcomes be measured?

Answer 3

1. Clinical outcomes
2. Functional outcomes
3. Patient satisfaction outcomes
4. Cost

Question 4

What are some large scale Q&S inquiries in Australia and was clinical governance introduced.

Answer 4

Similar to UK: increasing consumer involvement in healthcare combined with discovery of things that have gone wrong.

• Douglas Inquiry WA 2001 - Was an inquiry into hte obstetric and gynae services at King Edward Mem Hospital 1990-2000
  finding: lack of safety and quality systems at state, board and hospital level - infeffective accrediation, credentialing and incident reporting system. Poor mortality reporting and ix and lack of inter-hospital comparitive data analysis
• Special Comission Inquiry into Camden and Cambletown 2004
• Bundaberg 2005

Question 5

Process diagramming
Square = 
Arrow = 
Diamond = 
Oval =

Answer 5

Square = events/steps
Arrow = sequence/chronology
Diamond = Decision/question
Oval = start/end of process

Question 6

Name the clinical governance failure which was pivotal in increasing focus on quality and safety in the NHS

Answer 6

Bristol Babies Scandal - 1995

• 35 Deaths and many more brain damage to babies undergoing arterial switch procedure
• Key recommendation: need better regulation of quality and safety needed and periodic revalidation for health professionals

Question 7

Healthcare is a process. What is a process?

Answer 7

Processes are the series of events that lead to an OUTCOME

Question 8

What are the differences in CG in Aus vs UK

Answer 8

• Not all under NHS, There are fragmented fiscal and administrative responsibility
• States are responsible for implementing their own CG policies.
• National Health Reform Agreement 2011
  National Safety and Quality Standards
  NEAT targets