Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review
Objectives Our 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.Setting Primary care.Participants Chronic...
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| Format: | Article |
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BMJ Publishing Group
2018-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/8/7/e020626.full |
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| author | Walter Ricciardi Gianfranco Damiani Alessandra Buja Vincenzo Baldo Mark H Ebell Roberto Toffanin Mirko Claus |
| author_facet | Walter Ricciardi Gianfranco Damiani Alessandra Buja Vincenzo Baldo Mark H Ebell Roberto Toffanin Mirko Claus |
| author_sort | Walter Ricciardi |
| collection | DOAJ |
| description | Objectives Our 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.Setting Primary care.Participants Chronic Care Model by Wagner et aland Clinical Governance statement by Scally et alwere taken for reference. Each was reviewed, including their various components. We then conceptualised a new framework, merging the relevant aspects of both.Interventions We 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.Results All 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.Conclusions A 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. |
| format | Article |
| id | doaj-art-4dcc03b642e847bd97e6aaf278014c79 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-4dcc03b642e847bd97e6aaf278014c792025-02-09T20:30:09ZengBMJ Publishing GroupBMJ Open2044-60552018-07-018710.1136/bmjopen-2017-020626Developing a new clinical governance framework for chronic diseases in primary care: an umbrella reviewWalter Ricciardi0Gianfranco Damiani1Alessandra Buja2Vincenzo Baldo3Mark H Ebell4Roberto Toffanin5Mirko Claus6Catholic University of the Sacred Heart Rome, Rome, ItalyDepartment of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, Padua, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, Padua, ItalyDepartment of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, USA2 Past Administrative Directorship, ex-ULSS 4, Veneto, Italy3 Department of Cardiologic, Vascular, Thoracic Sciences and Public Health, School of Hygiene and Preventive Medicine, University of Padova, Padova, ItalyObjectives Our 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.Setting Primary care.Participants Chronic Care Model by Wagner et aland Clinical Governance statement by Scally et alwere taken for reference. Each was reviewed, including their various components. We then conceptualised a new framework, merging the relevant aspects of both.Interventions We 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.Results All 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.Conclusions A 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.https://bmjopen.bmj.com/content/8/7/e020626.full |
| spellingShingle | Walter Ricciardi Gianfranco Damiani Alessandra Buja Vincenzo Baldo Mark H Ebell Roberto Toffanin Mirko Claus Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review BMJ Open |
| title | Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review |
| title_full | Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review |
| title_fullStr | Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review |
| title_full_unstemmed | Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review |
| title_short | Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review |
| title_sort | developing a new clinical governance framework for chronic diseases in primary care an umbrella review |
| url | https://bmjopen.bmj.com/content/8/7/e020626.full |
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