Improving quality through clinical governance in primary health care

Abstract

Ensuring health care that is safe and of high quality is as much a priority for the primary care sector as it is for hospitals. The National Health and Hospital Reform Commission has made a number of recommendations which foreground the need for accountable services that have overarching quality improvement systems. However, attempts to integrate quality assurance and improvement programs into the everyday work of the Australian primary care sector must contend with the diversity of service types, the lack of systematised communication within and between these service types, and variation of managerial structures. This review explores clinical governance, a systematic and integrated approach to ensuring services are accountable for delivering quality services. Clinical governance as a policy framework was part of the National Health Service reforms of the early 1990s, but similar initiatives have also been developed in the US and Europe. The applicability of these initiatives to the diverse Australian primary care sector has not previously been studied.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy