Quality, Risk, and Control in Health Care

Quality, Risk, and Control in Health Care

Quality, Risk, and Control in Health Care

Quality, Risk, and Control in Health Care

Synopsis

"With better governance a key issue in the NHS boardroom, this book provides a comprehensive underpinning to future developments."Roger Moore, Chief Executive, NHS Appointments Commission, UK"This book provides a much needed integration of different streams in the quality movement, examining the need and methods for control and accountability as well as the continuous improvement approach."John Ovretveit, The Karolinska Institute Medical Management Centre, Stockholm, Sweden"This excellent book is both informative and challenging...[it] helps us work our way through the contradictory and often inconsistent health maze that is bound by quality, risk, control, governance, trust, regulation, private activity, accountability, assurance and outcome."Adam Graycar, Cabinet Office of South AustraliaThis book explores the concepts of trust, control and risk management as key components of organisational accountability in the public sector. It explores how the concept of risk management has been introduced into the public sector and how this has impacted on the definition of governance in the National Health Service. It also addresses the concept of controls assurance by placing it in the context of developments both in local health care management and central government. Key questions that are addressed include:
• How can devolved public sector organisations be held accountable?
• What is the relationship between risk, control and governance?
• How do private sector ideas about governance translate into the provision of public health services?Quality, Risk and Control in Health Care is essential reading for health policy makers, health practitioners and professionals, as well as students and academics in the fields of health policy, health services management, social policy and public policy.

Excerpt

For many years there has existed a popular view that management is unnecessary in health care. Doctors and nurses left to their own devices are able to provide the best health care. However, there is no universal agreement on the definition of 'best'. In our western-style democratic society, we are concerned equally with ensuring that decisions are taken in ways that conform to our values which, in turn, defines what we mean by good treatment. Recent events such as the retention of children's organs at Alder Hey Hospital demonstrate that doctors and other health care professionals may not share public values about what is perceived as good practice. Therefore, in order to address our concerns about what we mean by best health care, we have to address not only issues of clinical practice but also the issues of governance, decision making and better management processes - to ensure the organizations are able to deliver what we are asking of them. In short, we are seeking a process of 'New Governance', which will enable us to receive health care in the way we want it, putting our values - as patient and funder of health care - at the centre of decision making in health care.

The ideas underpinning New Governance in health services have their genesis in a number of different areas. It has long been recognized that any producer or employer can, through their production processes, cause harm to their staff, customers or society at large. Health services are as open to criticism as any organization that they can create pollution, or that they can damage staff through accidents. Protection from pollution and harm to staff are provided for in legislation, which applies as much to health care organizations as it does to any other employer or producer. Boards of NHS organizations are expected to follow legal requirements to ensure they are good employers and protectors of their local communities. Health care organizations deal with large amounts of public money, and are expected to protect themselves against risk of fraud and impropriety. Health care organizations are expected to deliver on government's promises to provide improved health care delivery, which requires a broader and more strategic assessment of risk associated with the management of their organizations. In addition, health care organizations face some specific risks. The very nature of health care means that patients can be put at risk by health care interventions and the risks associated with these are now recognized and health services are expected to deal with them. Almost every activity provided by a health care organization or its staff in dealing with the public entails a risk to patient health and safety, and health care managers are required to ensure that patients are afforded protection from harm wherever possible.

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