1. INFORMATION LAW AND CLINICAL GOVERNANCES
DR.ANJALATCHI MUTHUKUMARAN
PROFESSOR CUM VICE PRINCIPAL AND NURSING SUPERINTENDENT
ELMCH, ERA COLLEGE OF NURSING , ERA UNIVERSITY
LUCKNOW -226003

2. CONTENTS OF CLINICAL GOVERNANCE
Seven pillars of Clinical Governance
1. Patient and public involvement (PPI)
2. Risk management
3. Staffing and staff management
4. Education and Training
5. Clinical effectiveness and research
6. Using clinical information & IT
7. Clinical Audit

3. HEALTH CARE PROFESSIONAL BECAME LIKE
 We are technical expert in our fields
 We are leaders
 We are managers
 We are accountable for the patient care and health
care services
 We are changes agents
 We are respected highly in the community
 We are responsive
 We are good communicator and negotiators
 We are kind and empathic
 We are decent and disciplined because we are study
like human right, subject are anatomy, physiology ,
nursing procedure , psychology, sociology, child
health, mental health etc

4. AS A HEALTH CARE SERVICE

5. CLINICAL GOVERNANCE
INTRODUCTION
 Clinical Governance is a strategic framework for the
development of high quality healthcare "A framework through
which organizations are accountable for continuously improving
the quality of their services and safeguarding high standards of
care by creating an environment in which excellence in clinical
care will flourish" – NHS, UK

6. MEANING OF CLINICAL GOVERNANCES
 “clinical governance is a way of making sure that everyone who
passes through health system is well cared for” or System that
enable staff to work in the best possible way + Staff performing
to the highest possible standards

8. CLINICAL GOVERNANCE COMPONENTS
Seven pillars of Clinical Governance
 Patient and public involvement (PPI)
 Risk management
 Staffing and staff management
 Education and training
 Clinical effectiveness & Research
 Using clinical information & information technology (IT)
 Clinical audit ,Peer review ,Data analysis
 Clinical performance by individual evaluation
 Success path way like SOP, Policies, Standard, Guidelines etc

9. PATIENT AND PUBLIC INVOLVEMENT (PPI)
 Patient and public involvement PPI is about
 Ensuring services meet the need of the patients
 Patient and public feedback is used to improve services
 Patients and the public are involved in the development of
services and the monitoring of treatment outcomes

10. RISK MANAGEMENT
 Risk Management involves having robust systems in place to
understand, monitor and minimize the risks to patients and staff and to
learn from mistakes
 Complying with protocols
 Learning from mistakes and near-misses
 Reporting adverse events
 Assessing the risks – probability of occurrence, impact
 Promoting blame free culture

11. STAFFING AND STAFF MANAGEMENT
 Appropriate recruitment and management of staff like credential and
privileges base
 Ensuring that underperformance is identified by performance
appraisal and addressed to correct by In-services education ,CNE,
Workshop, Conferences etc
 Encouraging staff retention by motivating and developing skills by
conducting short course like BLS, ACLS, PALS, HIC, First Aids ,SBA ,
Disaster modules to the staff
 Providing good working conditions ,encourage to participate direct
patient care , continuous monitoring by supervisor etc
 Promotion, incentives, special allowances to the employee make them
good involvement of services

12. EDUCATION AND TRAINING
 Providing appropriate support available to enable staff to be
competent in doing their jobs and to develop their skills .so that they
are up to date Professional development needs to continue through
life long learning process like GNM, P.B.Sc , M.Sc , Ph.D etc
 Providing opportunity to go higher studies through CNE process.
 Provide stipend for additional degree education process.

13. CONTINUED
 Attending courses and conferences (commonly referred to as CPD –
Continuous Professional Development)
 Taking relevant exams
 Regular assessment, designed to ensure that training is appropriate
 Appraisals (which are a means of identifying and discussing
weaknesses, and opportunities for personal development)

14. CLINICAL EFFECTIVENESS & RESEARCH
 Clinical effectiveness implies ensuring that everything we do is
designed to provide the best outcomes for patients. "the right thing to
the right person at the right time in the right place”

15. CONTINUED
In practice, it means:
• Adopting an evidence-based approach in the management of patients
• Changing your practice, developing new protocols or guidelines based
on experience and evidence if current practice is shown inadequate.
• Implementing guidelines, protocols and other national standards to
ensure optimal care
• Conducting research to develop the body of evidence available and
therefore enhancing the level of care provided to patients in future

16. USING CLINICAL INFORMATION & IT
This is to ensure that
• Patient data is accurate and up-to-date
• Confidentiality of patient data is respected
• Full and appropriate use of the date is made to measure quality of
outcomes (e.g. through audits) and to develop services tailored to local
needs

17. CLINICAL AUDIT
 Clinical audit is a quality improvement cycle that involves
measurement of the effectiveness of healthcare against agreed and
proven standards for high quality, and taking action to bring practice in
line with these standards so as to improve the quality of care and
health outcomes
 Clinical audit is a systematic process of looking at your practice and
asking:
 What should we be doing?
 Are we doing it? If not, how can we improve?

18. CLINICAL AUDIT
 Audit cycle
 1) Selecting a topic
 2) Agreeing standards of best practice (audit criteria)
 3) Collecting data.
 4) Analysing data against standards
 5) Feeding back results.
 6) Discussing possible changes.
 7) Implementing agreed changes
 8) Allowing time for changes to embed before re-auditing.
 9) Collecting a second set of data
 10) Analyzing the re-audit data
 11) Feeding back the re-audit results.
 12) Discussing whether practice has improved

19. AUDIT CYCLE FOR MAINTENANCE OF QUALITY OF HEALTH
CARE

20. CLINICAL AUDIT

21. DIFFERENCE BETWEEN CLINICAL AUDIT AND RESEARCH

22. RESPONSIBILITIES OF CLINICAL GOVERNANCE
 Monitoring, and where relevant, enforcing compliance with standards
and regulations. Sharing information and intelligence in relation to
patient-safety.
 Promoting a culture of continuous improvement and learning. Acting
decisively to protect the public when risks to patient care or wellbeing
emerge.

23. SUMMARY
 Clinical governance is the set of relationships and responsibilities
established by a health service organisation between its state or
territory department of health, governing body, executive, workforce,
patients, consumers and other stakeholders to ensure good clinical
outcomes.

24. CONCLUSION
 It ensures patients that the health care they receive is of the highest
standard and also holds service providers accountable for clinical care
that falls short of those standards.

25. REFERENCES
 The New NHS: Modern and Dependable.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/d
ocuments/digitalasset/dh_4014486.pdf (Accessed 29/10/2012).
 Department of Health (1999) Making A Difference: strengthening the nursing,
midwifery and health visiting contribution to health and healthcare.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsP
olicyAndGuidance/DH_4007977 (Accessed 29/10/2012).
 Department of Health (2000) An Organisation with a memory.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/d
ocuments/digitalasset/dh_4065086.pdf (Accessed 29/10/2012).
 Hallett, L. & Thompson, M. (2001) Clinical Governance: A Practical Guide
For Managers. London: HSJ Public Sector Management. O‟Neil, S. (2000)
Effective Risk Management Strategies, Professional Nurse Royal College of
Nursing (1996) The Royal college of Nursing Clinical Effectiveness Initiative
– A Strategic Framework. London, RCN.