We have named the sections of this resource in line with themes appearing in the standards documents from the four countries (Care Quality Commission 2010, Department of Health, Social Services and Public Safety 2006, NHS Quality Improvement Scotland 2005, Welsh Assembly Government 2010):
- Patient focus - how services are based on patient needs
- Information focus - how information is used
- Quality improvement - how standards are reviewed and attained
- Staff focus - how staff are developed
- Leadership - how improvement efforts are planned.
It might help to think of how these themes connect.
How clinical governance works in an organisation depends on contributions from each theme. The focus is on the interaction of the parts with a central role for information (the hub of the wheel). This image is similar to the clinical microsystems model (Nelson et al 2002, p.483).
Clinical Governance and the Principles of Nursing Practice
The concept and key themes of clinical governance are further illustrated by and embedded in the RCN Principles of Nursing Practice. The Principles articulate what can be expected of nursing in any setting regardless of provider, and were developed with a range of stakeholders, including nurses, patients and service users.
The Principles have clear links with the key themes of clinical governance. They:
- describe the importance of care focused on individual needs (patient focus)
- describe nurses' pivotal contribution to communication (information focus)
- provide a basis for quality improvement and demonstrate the contribution of nursing to quality care (quality improvement)
- emphasise the importance of multi-disciplinary working (staff focus) and leadership skills (leadership).
Care Quality Commission (2010) Essential standards of quality and safety - see Guidance about compliance. Care Quality Commission website.
Department of Health, Social Services and Public Safety (2006) The Quality Standards for Health and Social Care. Belfast: DHSSPS.
Nelson EC, Batalden PB, Huber TP et al (2002) Microsystems in Health Care: Part 1. Learning from High-Performing Front-line Clinical Units. The Joint Commission Journal on Quality Improvement. 28 (9) pp. 472-493.
NHS Quality Improvement Scotland (2005) Clinical Governance and Risk Management; achieving safe, effective, patient-focused care and services. Edinburgh: NHS QIS.
Welsh Assembly Government (2010) Doing well, doing better: standards for health services in Wales. Cardiff: Welsh Assembly Government.