Improving quality through clinical governance in primary health care

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• Improving quality through clinical governance in
  primary health care

Christine Phillips, Christopher Pearce, Jo
Travaglia, Marjan Kljakovic, Sally Hall, Simon
deLusignan, Tom Love
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Clinical governance

• a systematic and integrated approach to
  assurance and review of clinical responsibility
  accountability that improves quality and safety
  resulting in optimal outcomes
• WA Office Quality Safety in Health Care

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Clinical governance

• a systematic and integrated approach to
  assurance and review of clinical responsibility
  accountability that improves quality and safety
  resulting in optimal outcomes
• WA Office Quality Safety in Health Care

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Audit Accreditation Regular meetings Structured
review
Regulation CME Training
Workers
Tools
Quality of care Accountability Patient
satisfaction
Team structures Organisational culture IT
environment
Patient boards Complaints mechanisms
Patients
Contexts
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Challenges in the Australian primary health care
context

• Australian primary care is relatively fragmented
• Some of the drivers for CG (corporate governance,
  linkage with other health sectors) missing
• ? Cultural valuing of independence and autonomy
• Changes to facilitate CG include changing team
  structures and Divisions

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Research questions

• What CG models
• work in primary care settings in Australia
  and internationally?
• work in other health settings but might be
  relevant to primary care?
• might impact upon different dimensions of
  quality of care?
• might suit different service settings?
• represent best value for money?
• will be accepted and taken up in general
  practice?

What works in PC?
Give us more specifics?
Data for policy choices
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Audit Accreditation Regular meetings Structured
review
Regulation CME Training
Workers
Tools
Quality of care Accountability Patient
satisfaction
Team structures Organisational culture IT
environment
Patient boards Complaints mechanisms
Patients
Contexts
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Conclusion

• Vast amount of data in all four domains
• Development of models is a secondary process
• In Australia, likely to find that a focus on
  contexts and possibly patients as primary
  elements may be most useful

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• The research reported in this presentation is a
  project of the Australian Primary Health Care
  Research Institute, which is supported by a grant
  from the Australian Government Department of
  Health and Ageing.