Κλινικός έλεγχος και κλινική διακυβέρνηση στις υπηρεσίες υγείας
Clinical audit and clinical governance in health care services
KeywordsΠοιότητα ; Κλινικός έλεγχος ; Κλινική διακυβέρνηση ; Ελεγκτικές εταιρείες ; Ελεγκτικός κύκλος ; Προκλητή ζήτηση ; Quality ; Clinical audit ; Clinical governance ; Auditing companies ; Audit cycle ; Induced demand
The social and financial environment on a national and international level showcases conflicting trends. The international economy is in recession, with the most robust countries searching for ways to restore their former financial glory, while at the same time the progress of medicine in combination with the improvement of quality of life amplifies the demand for health services. Clinical audit as a “tool” of clinical governance attempts to bridge these contrasts by curbing the expenditure through the improvement of efficiency and effectiveness of clinical practice. With clinical audit we aim to improve the provision of health services through ongoing assessment of infrastructure, procedures and results of the provided care (Donabedian, 1996). It is a cyclic process during which some criteria-goals are initially set, and after a systematic assessment, the degree of satisfaction is evaluated and, where necessary, changes are suggested. Clinical governance constitutes the framework within which a healthcare unit should operate in order to constantly improve the quality of its services, thus guaranteeing high standards of healthcare. The goals are associated with the medical appropriateness and necessity of healthcare services which the patient receives. The establishment of protocols, the evidence-based medical practice and the development of quality assessment methοds are sine qua non elements for its successful operation. The continuous fiscal adjustment and the streamlining of expenditure which has been attempted in Greece lately call for the adoption of clinical governance and clinical audit practices. In the private sector the results appear more impressive while the prospects for extension in the pubic healthcare system seem realistic.