Clinical Governance: Structure, Management, and Principles Report

This report provides a detailed overview of clinical governance within the New Zealand healthcare system. It defines clinical governance, emphasizing its role in ensuring high standards of clinical care and continuous service improvement. The report outlines key elements like openness, clinical effectiveness, training and education, research and development, clinical audits, and risk management. It then examines the clinical governance framework in New Zealand, highlighting the importance of openness and transparency, clinical effectiveness, and continuous professional development. The report also discusses the clinical governance structure, based on pillars like accountability, transparency, probity, and fiduciary duty, and the principles that guide it, such as a culture of trust, commitment to continuous development, and rigorous responses to incidents. Furthermore, the report defines clinical management, its framework, structure, and principles, emphasizing its role in maintaining safety and quality in healthcare settings. The report includes references to support the information.

Running head: CLINICAL GOVERNANCE
CLINICAL GOVERNANCE
Name of the student:
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Author note:

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1.0 Clinical governance:
1.1 Define clinical governance:
Clinical governance may be defined as the comprehensive as well as new and
powerful mechanism that ensures high standard of clinical care which needs to be
followed throughput NHS. It also focuses on the continuous improvement of the
service for better service delivery for the patients. Some of the elements which when
followed by the healthcare professionals bring out positive result in patient care are
teamwork, ownership, proper resource effectiveness, better patient care, proper
learning effectiveness as well as leadership (Gauls and Horsburgh, 2014). There are
five important elements of the clinical governance which when achieved properly will
lead to safe, culturally competent practice that will result in better patient satisfaction.
These are openness, clinical effectiveness, training and education, research and
development. clinical audits and risk managements (Prenestini et al., 2015).
1.2 Clinical governance framework in healthcare New Zealand
1.2.1 Openness and transparency
Openness in the discussions about healthcare, its issues, positive as well as
negative aspects by both healthcare professionals, government as well as
normal citizens is necessary to provide a transparency to the entire clinical
governance framework. Stalwarts are of the opinion that processes which
are wide open for the benefit of public scrutiny is essential. However care
should be taken that it does not breach ethical concerns and therefore it
should respect confidentiality of individual patients as well as the
professionals. Each and every matter regarding healthcare should be

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discussed openly which is indeed an important part of the quality
assurance.
1.2.2 Clinical effectiveness
Clinical effectiveness may be defined as the measure of the limit to which
a particular intervention is found to be useful. The effectiveness of the
intervention needs to be measured by not only the efficiency that the
intervention accompanies or the amount of safety it ensures. It also covers
the importance of using interventions whose positive aspects are proved
through randomized trials (Smith et al., 2014). Development of proper
guidelines and protocols based on different evidence based practices has
become the main foundations of clinical governance and therefore help in
guiding the professional in correct way. Clinical effectiveness also depend
on the continuity of care, holistic care depending on the patient’s needs as
well as a sensitive care based on the personal preferences of the patient’s
needs.
1.2.3 Education and training
Each and every healthcare professionals should be well acquainted with
the modern practice, modern technologies used in healthcare in the
different medical innovations going on. Often the training provided the
professional before they join their profession gets outdated as medical
science is always on a roll and come up with more beneficial prospects
every time. Therefore, professionals should try their best to participate in
continuous professional development so that they can learn modern skill,

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enhance their knowledge, and develop understanding of recent modern
technologies and others. All thee will ensure a better acre for patient with
higher patient satisfaction. Funding of the training sessions have been an
issue in the healthcare centers but different funding systems has been
initiated which ensures that all the professionals get scope for
development.
1.2.4 Research and development
Continuous research and development are extremely important in clinical
governance as they help in ensuring the safety of application of different
interventions and practices. The time taken between the establishment of
the effectiveness of certain interventions and then applying to medical
practice should be reduced so that better care can be delivered and
morbidity level can be decreased (Galletly et al., 2016). For the promotion
of implementation of the research evidence in the healthcare setting,
different tools which are useful are critical appraisal of literatures form
famous journals, project management, and also the development of
protocols and guidelines and other implementation strategies.
1.2.5 Risk management
Providing healthcare is a risky profession and therefore all the important
stakeholders should be properly aware and educated so that the risk can be
avoided. If the patients comply with the different statutory regulations,
they can avoid risk. They should make themselves educated about their
health issues so that they can maintain their symptom effectively. The

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practitioners can avoid risks of infections by immunizing the properly and
developing a safe environment. They should also provide interventions
which are up to date and follow cultural competence o that they may be
safe form legal and ethical concerns. Besides reducing risks for patients
and professionals, the organization should also reduce the risk on them by
ensuring proper high quality employment and well designed policies on
public involvement.
1.2.6 Clinical audits
Clinical audits may be defined as the evaluation method which mainly acts
by reviewing the clinical performance of the professionals and thereby
nursing such professional according to a given standards to find scope of
betterments (Weller, Boyd & Cumin, 2014). These are usually conducted
by eminent and experienced professionals and researchers who tend to
bring out either a qualitative or quantitative analysis of the performance,
scope of betterments, requirement of individual training and other, these
ensures a safe environment in the healthcare and identifies the necessities
in development of skill and knowledge of the professionals of mark the
changes needed by the organization.
1.3 Clinical governance structure in healthcare New Zealand:
Governance in healthcare services in New Zealand is multifaceted. They are mainly
based on the four important pillars that build the structure of the entire systems in the
nation. These are accountability, transparency, probity as well as fiduciary duty.
These are mainly operationalised with the help of another four components. These are

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professional maturity which means the ability of an individual to be accountable for
his or she owns decisions making in governance. It is basically a dimension of
decision making based on professional experience life experience, education as well
as technical skills. The next important components of the structure is maintaining the
quality and safety of the different healthcare centers by proper funding of the
government, proper allocation of the resources and ensuring allocation of competent
and responsible professionals (Galletly et al., 2016). Quality and safety are guided by
proper guidelines, rules, audit, professional thesis, morality of clinician and
institutional memory. The third is the balanced level of power and tensions between
the stakeholders with robust debate, recognition of other’s competence, transparency
in organizations and confidence boosting. The balance can be maintained by
economic rationality, ideologies, cultural power, conflict of interest and profession
hood
1.4 Clinical governance principles in healthcare New Zealand:
1.4.1 culture of trust
A harmonious relationship should be present among all the stakeholders,
patient-professionals, intra-professionals, and also of the stakeholders
within the organization. This can be done through respecting each other’s
suggestions, decisions, emotions and properly communicating issues and
congratulating other’s achievements. A Culture of trust between all
ensures safety in workplace with proper mental satisfaction which keeps
everyone happy and content.
1.4.2 commitment to continuous development

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All the professionals should be responsible as well as accountable for their
own performance. When coming into the profession, they should make up
the mind that they are serving human and they should provide compassion,
empathy and dedication to make their best to serve human kind (Orton &
Hocking, 2017). They should therefore take continuous professional
development to develop their knowledge and skills with evidence based
practices and attending training courses so that they can provide the best
care to patients which are modern.
1.4.3 rigorous systems of response to incidence
Every healthcare professional should respond to different incidences
occurring in the organization starting form patient complaints, nursing
issues, conflicts of power, work pressure issues and others. When the
issues will be properly handled by responsible stakeholders, it will
automatically lead to smooth flow of work in the healthcare (Smith, Latter
& Blenkinsopp, 2014).
1.4.4 key organizational and clinical performance indicators
Some of the abovementioned indicators are clinical effectiveness and
safety measurement of interventions, efficiency of services provided by
individuals, staff orientation and staff safety, responsive governance and
environmental safety as well as patient centeredness (Hastings et al.,
2014).
2.0 Clinical management (Safety and quality)
2.1 Define clinical management

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Clinical management in safety and maintenance of healthcare centers may be defined
as the comprehensive management conducted by the stakeholders of the organizations
by conducting duties and responsibilities that associate with the smooth uninterrupted
flow of service delivery to the patient and at the same time ensure that care provided
in high on quality and dedication (Currie et al., 2017). This may include proper
allocation of nurse patient ratio, proper allocation of resources, proper management of
conflicts and power, caring for the health of the professionals, management of skills
of the professional, ensuring the conductance of proper training classes, taking of
survey at intervals and many others. When all these are properly managed, it leads to
safe and quality care of patients (Kwedza et al., 2017).
2.2 Clinical management framework
Clinical management framework mainly depends on five important factors that
ensures proper quality is maintained or not in the organization. These are
organizational leadership as well as strong management systems for the maintenance
of culture of safety (Gauld & Horsburgh, 2015). More importance would be given to
quality improvement. Employers and managers should also involve in workforce
development where the workers will not only be physically and mentally fit but are
also happy and emotionally stable. Such workers produce higher productivity. The
managers should also look over the consumers concerns. Their care and complaints
and also provide strategies for community management.
2.3 Clinical management structure
A clinical management structure mainly works on four important foundations. These
are managers first depicting what changes they need to take for clinical management

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and what goals they want to finalize. The second foundation mainly involves the
taking of initiatives which put things in place as planned so that proper changes can
be brought out to meet goals (Hastings et al., 2014). The third is the checking of the
results that wherever the results brought out successful results or not. And the four
foundations would be to implement the planned the goal or engage in the system
which would ultimately lead to successful clinical management of the safety and
quality practices of the system (Gauld & Horsburg, 2014).
2.4 Clinical management principles.
Developing strategic directions and priorities for proper communication development
among the stakeholders is an important principle. Besides, proper planned way of
management, resource allocation, maintenance of a positive culture, complying with
the legislative requirements; following of proper organizational cultures are some
other principles (Prenestini et al., 2015). Correct evaluation of the performance for
measuring quality and safety would be also taken during clinical management. Roles
and responsibilities with proper clarity is another principle besides continuity of care
for patients.

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References:
Australian, R., & New Zealand College Of Psychiatrists Clinical Practice Guidelines Team For
Deliberate Self-Harm. (2016). Australian and New Zealand clinical practice guidelines
for the management of adult deliberate self-harm. Australian & New Zealand Journal of
Psychiatry.
Currie, J., Currie, J., Mateer, J., Mateer, J., Weston, D., Weston, D., ... & Harding, J. (2017).
Implementation of a clinical governance framework to 17 combat service support
brigade, Australian army. International Journal of Health Governance, 22(1), 15-24.
Galletly, C., Castle, D., Dark, F., Humberstone, V., Jablensky, A., Killackey, E., ... & Tran, N.
(2016). Royal Australian and New Zealand College of Psychiatrists clinical practice
guidelines for the management of schizophrenia and related disorders. Australian & New
Zealand Journal of Psychiatry, 50(5), 410-472.
Gauld, R., & Horsburgh, S. (2014). Measuring progress with clinical governance development in
New Zealand: perceptions of senior doctors in 2010 and 2012. BMC health services
research, 14(1), 547.
Gauld, R., & Horsburgh, S. (2015). Healthcare professionals’ perceptions of clinical governance
implementation: a qualitative New Zealand study of 3205 open-ended survey
comments. BMJ open, 5(1), e006157.
Hastings, S. E., Armitage, G. D., Mallinson, S., Jackson, K., & Suter, E. (2014). Exploring the
relationship between governance mechanisms in healthcare and health workforce
outcomes: a systematic review. BMC health services research, 14(1), 479.

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Hastings, S. E., Armitage, G. D., Mallinson, S., Jackson, K., & Suter, E. (2014). Exploring the
relationship between governance mechanisms in healthcare and health workforce
outcomes: a systematic review. BMC health services research, 14(1), 479.
Kwedza, R. K., Larkins, S., Johnson, J. K., & Zwar, N. (2017). Perspectives of rural and remote
primary healthcare services on the meaning and goals of clinical governance. Australian
journal of primary health.
Orton, Y., & Hocking, C. (2017). Clinical governance: Implications for occupational therapists
in Aotearoa New Zealand. New Zealand Journal of Occupational Therapy, 64(1), 14.
Prenestini, A., Calciolari, S., Lega, F., & Grilli, R. (2015). The relationship between senior
management team culture and clinical governance: Empirical investigation and
managerial implications. Health care management review, 40(4), 313-323.
Smith, A., Latter, S. and Blenkinsopp, A., 2014. Safety and quality of nurse independent
prescribing: a national study of experiences of education, continuing professional
development clinical governance. Journal of advanced nursing, 70(11), pp.2506-2517.
Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming barriers
to effective teamwork in healthcare. Postgraduate medical journal, 90(1061), 149-154.