Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review
| Autor: | Mirko Claus, Vincenzo Baldo, Roberto Toffanin, Walter Ricciardi, Alessandra Buja, Mark H. Ebell, Gianfranco Damiani |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Attitude of Health Personnel
health system framework Population health 03 medical and health sciences 0302 clinical medicine Patient satisfaction Nursing Health care Medicine Humans 030212 general & internal medicine Clinical Governance Cooperative Behavior Settore MED/42 - IGIENE GENERALE E APPLICATA Randomized Controlled Trials as Topic Chronic care Clinical governance business.industry Delivery of Health Care Integrated Research Professional development healthcare General Medicine primary health care Systematic review Patient Satisfaction Accountability Health Services Research business chronic disease 030217 neurology & neurosurgery |
| Zdroj: | BMJ Open |
| Popis: | ObjectivesOur goal is to conceptualise a clinical governance framework for the effective management of chronic diseases in the primary care setting, which will facilitate a reorganisation of healthcare services that systematically improves their performance.SettingPrimary care.ParticipantsChronic Care Model by Wagneret aland Clinical Governance statement by Scallyet alwere taken for reference. Each was reviewed, including their various components. We then conceptualised a new framework, merging the relevant aspects of both.InterventionsWe conducted an umbrella review of all systematic reviews published by the Cochrane Effective Practice and Organisation of Care Group to identify organisational interventions in primary care with demonstrated evidence of efficacy.ResultsAll primary healthcare systems should be patient-centred. Interventions for patients and their families should focus on their values; on clinical, professional and institutional integration and finally on accountability to patients, peers and society at large. These interventions should be shaped by an approach to their clinical management that achieves the best clinical governance, which includes quality assurance, risk management, technology assessment, management of patient satisfaction and patient empowerment and engagement. This approach demands the implementation of a system of organisational, functional and professional management based on a population health needs assessment, resource management, evidence-based and patient-oriented research, professional education, team building and information and communication technologies that support the delivery system. All primary care should be embedded in and founded on an active partnership with the society it serves.ConclusionsA framework for clinical governance will promote an integrated effort to bring together all related activities, melding environmental, administrative, support and clinical elements to ensure a coordinated and integrated approach that sustains the provision of better care for chronic conditions in primary care setting. |
| Databáze: | OpenAIRE |
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