clinical governance, clinical management, clinical practice

Do "clinical governance" definitions adequately distinguish between governance, management and practice functions?

The article published by Niamh M. Brennan, Maureen A. Flynn (2013) introduces three definitions to put the term in the correct place.

Clinical governance has benn viewed by many authors as an "umbrella term" and too ambiguous. The study finds 29 different definitions.

Definitions of clinical governance, clinical management, clinical practice proposed by the authors:

• Clinical governance. Structures, systems, and standards applying to create a culture, and direct and control clinical activities. Clinical accountability and responsibility, a sub-set of clinical governance, involves the monitoring and oversight of clinical activities, including regulation, audit, assurance and compliance by governors (such as boards of directors), regulators (such as governments and professional bodies), internal auditors and external auditors.

• Clinical management. Processes and procedures, including resourcing clinical staff, by managers to efficiently, effectively and systematically deliver high quality, safe clinical care.

• Clinical practice. Delivery by clinicians of high quality, safe clinical care in compliance with clinical policies and performance standards, in the interests of patients.

Two important questions to consider for those health care institutions that are trying to define who want to be:

"For effective governance, it is important that there be division of duties between governance roles and management and practice roles. It is a fundamental principle of governance that governors cannot oversee and monitor their own work."

"Clinical quality will not improve unless governors, managers and practitioners take personal responsibility for the positions they hold and the functions they perform."

photo: (*) Photosolde
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