Document Detail


The relationship between external and local governance systems: the case of Health Care Associated Infections and medication errors in one NHS trust.
MedLine Citation:
PMID:  20584705     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: 'Organisational governance'--the systems, processes, behaviours and cultures by which an organisation leads and controls its functions to achieve its objectives--is seen as an important influence on patient safety. The features of 'good' governance remain to be established, partly because the relationship between governance and safety requires more investigation.
AIMS: To describe external governance systems--for example, national targets and regulatory bodies--and an NHS Trust's formal governance systems for Health Care Associated Infections (HCAIs) and medication errors; to consider the relationships between these systems.
METHODS: External governance systems and formal internal governance systems for both medication errors and HCAIs were analysed based on documentary analysis and interviews with relevant hospital staff.
RESULTS: Nationally, HCAIs appeared to be a higher priority than medication errors, reflected in national targets and the focus of regulatory bodies. Locally, HCAIs were found to be the focus of committees at all levels of the organisation and, unlike medication errors, a central component of the Trust's performance management system; medication errors were discussed in appropriate governance committees, but most governance of medication errors took place at divisional or ward level.
DISCUSSION: The data suggest a relationship between national and local prioritisation of the safety issues examined: national targets on HCAIs influence the behaviour of regulators and professional organisations; and these, in turn, have a significant impact on Trust activity. A contributory factor might be that HCAIs are more amenable to measurement than medication errors, meaning HCAIs lend themselves better to target-setting.
Authors:
Angus Ramsay; Carin Magnusson; Naomi Fulop
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-27
Journal Detail:
Title:  Quality & safety in health care     Volume:  19     ISSN:  1475-3901     ISO Abbreviation:  Qual Saf Health Care     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136980     Medline TA:  Qual Saf Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  e45     Citation Subset:  H    
Affiliation:
NIHR King’s Patient Safety and Service Quality Research Centre, King’s College London, London, UK.
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