Clinical governance in primary care: a literature review

Tait, Allison R

doi:10.1111/j.1365-2702.2004.00949.x

Cited by 28 publications

(21 citation statements)

References 11 publications

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“…Clinical governance has been described as “changing the way people work; demonstrating that leadership, teamwork and communication is as important to high quality care as risk management and clinical effectiveness” [142]. It includes professionalism and accountability, which may not always be apparent, for example reflected in the high rate of absenteeism among a sample of primary health care workers in Tanzania [44].…”

Section: Resultsmentioning

confidence: 99%

Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

Toit¹,

Faal²,

Etya’ale

et al. 2013

BMC Health Serv Res

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BackgroundThe impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective.MethodsA scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework.ResultsLimited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care.ConclusionEvidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices. Multi-national research may provide guidance about how to scale up eye health interventions that are integrated into primary health systems.

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Section: Resultsmentioning

confidence: 99%

Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

Toit¹,

Faal²,

Etya’ale

et al. 2013

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…This accountability mandate for quality was novel, and prior to the bill, the government required only financial reporting. The line of accountability for delivery of quality care by general practice staff, is currently through the Chief Executive of the Primary Care Trust, the organization that allocates NHS funds to general practices (Tait 2004, Woodward 2006, Hoare et al. 2008).…”

Section: Resultsmentioning

confidence: 99%

The role of Government policy in supporting nurse‐led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review

Hoare

Mills

Francis

2011

Journal of Advanced Nursing

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“…), including the communication plan to prepare participating FMG and all partners, in order to facilitate change management; and (2) ensuring the implementation and proper roll-out of the intervention (maintaining an appropriate standardized level of intervention and providing support for case management nurses, etc.). The Clinical Project Coordinator will be responsible for clinical governance in coordinating care within the network of each CSSS [43]. This clinical governance will allow the Clinical Project Coordinator to establish the required intervention treatment pathways, with the support of the two primary care managers involved, as needed.…”

Section: Methodsmentioning

confidence: 99%

Case management and self-management support for frequent users with chronic disease in primary care: a pragmatic randomized controlled trial

Chouinard

Hudon

Dubois

et al. 2013

BMC Health Serv Res

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BackgroundChronic diseases represent a major challenge for health care and social services. A number of people with chronic diseases require more services due to characteristics that increase their vulnerability. Given the burden of increasingly vulnerable patients on primary care, a pragmatic intervention in four Family Medicine Groups (primary care practices in Quebec, Canada) has been proposed for individuals with chronic diseases (diabetes, cardiovascular diseases, respiratory diseases, musculoskeletal diseases and/or chronic pain) who are frequent users of hospital services. The intervention combines case management by a nurse with group support meetings encouraging self-management based on the Stanford Chronic Disease Self-Management Program. The goals of this study are to: (1) analyze the implementation of the intervention in the participating practices in order to determine how the various contexts have influenced the implementation and the observed effects; (2) evaluate the proximal (self-efficacy, self-management, health habits, activation and psychological distress) and intermediate (empowerment, quality of life and health care use) effects of the intervention on patients; (3) conduct an economic analysis of the efficiency and cost-effectiveness of the intervention.Methods/DesignThe analysis of the implementation will be conducted using realistic evaluation and participatory approaches within four categories of stakeholders (Family Medicine Group and health centre management, Family Medicine Group practitioners, patients and their families, health centre or community partners). The data will be obtained through individual and group interviews, project documentation reviews and by documenting the intervention. Evaluation of the effects on patients will be based on a pragmatic randomized before-after experimental design with a delayed intervention control group (six months). Economic analysis will include cost-effectiveness and cost-benefit analysis.DiscussionThe integration of a case management intervention delivered by nurses and self-management group support into primary care practices has the potential to positively impact patient empowerment and quality of life and hopefully reduce the burden on health care. Decision-makers, managers and health care professionals will be aware of the factors to consider in promoting the implementation of this intervention into other primary care practices in the region and elsewhere.Trial RegistrationNCT01719991

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Clinical governance in primary care: a literature review

Cited by 28 publications

References 11 publications

Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

The role of Government policy in supporting nurse‐led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review

Case management and self-management support for frequent users with chronic disease in primary care: a pragmatic randomized controlled trial

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