Welcome to the Quality and Clinical Governance Learning Support Material. We hope you will enjoy studying this module and that you will develop your own practice approach to managing quality in your professional capacity.

Quality has become important to healthcare organisations all over the world, primarily because concern has arisen over patient safety (Singh 2009) and there is a need to demonstrate value for money, efficiency and effectiveness. Continually improving the quality of healthcare provided is important for both patients and staff. Improving the quality of care does not necessarily mean increased costs to organisations and can be cost-effective.

In manufacturing industries, poor quality often results in higher numbers of defective parts that must be scrapped or reworked. In service industries, poor quality often results in inefficiencies and unsatisfied customers who either demand satisfaction or simply take their business to a competitor. In both settings, poor quality impacts employee morale, professional development and retention' (Birnbaum and Van Buren, 2010: 81).

In Hong Kong the focus has been on managing within financial constraints as well as ensuring that quality of the service is maintained and developed.

Hospital Authority Annual Plan

In Hong Kong the Hospital Authority publishes an Annual Plan. For the first time in 2009 this included a three-year 'Strategic Service Plan... to address three inter-related key challenges:

1. Manage growing service demand.
2. Ensure service quality and safety.
3. Maintain an adequate workforce.'

One of the key objectives in the 2009 - 2010 Hospital Authority Plan is to ensure that quality health care is not only delivered safely but continuously updated and improved and this involves clinical governance. Accreditation of services is also becoming important within Hong Kong health care organisations.

Another key objective is to improve workforce morale through in-service training and continued professional development.

Further policy i.e. the HA Annual Plan 2013-2014 and Hospital accreditation wil be discussed in unit 2; however, from the above it is clear that improving qualit) care within Hong Kong is a key priority and using clinical governance will facilitab the development of this care. This module, will examine what makes quality an strongly encouraged to use the full word count as this will enable you to explore your issue in depth and will thus show a good understanding of quality and clinical governance.

The maximum word count for the assignment is 3,000 + / - 10% and work over this limit will not be read. Please note the reference list at the end of your assignment and tables / diagrams are not included in the word count.

Confidentiality

To ensure confidentiality you must not specify the name of the place where you work but to refer to it as "the place of my employment".
Reference list

It is important to follow the HARVARD referencing system. At the end of your assignment. list all the references you have used within your assignment. Put them in alphabetical order using the author's surname first 0.e. the family name NOT the given name).

• Read the generic marking criteria below. and the learning outcomes for the module and check that your assignment meets the criteria.

• Check that you ha\,e an introduction, main body and conclusion and run a spell check

• Select no more than 3 strategies/theories from clinical governance. One of the theories that you must discuss is audit. Discuss audit last of all, because this is the strategy that is used to evaluate whether the application of clinical governance has reduced incidence of your quality issue.

• Explain each theory and then make some suggestions on HOW each theory could be used in practice to resolve your quality issue. It is very important to give some examples of strategies that could be used e.g. if your quality issue is about pressure sores and you've discussed

• Education and Training then you might discuss including a workshop on 'the management of pressure sores'.

• Possible theories that you could include - quality circles, integrated care pathways, risk management, education and training, research based practice and clinical effectiveness, complaints and audit.

• Summarise the key points discussed in your essay; do not just describe the structure of your work

• It is important not to bring any new ideas / literature into the conclusion.

This essay will first of all discuss the importance of clinical governance. It will then go on to analyse the above quality issue using Ishikawa's fishbone.. Finally this essay will
Please note that the introduction is not a lengthy discussion and should be no more than one side of A4.
Analysis

• This is where you analyse the situational factors, combine the theory and literature and apply one quality tool to analyse the causes of your workplace issue.

• Use 1 tool e.g. SWOT, 3 organisational dimensions, Maxwell 6, Ishikawa.

• Explain the theory of this tool and support your discussion with references and then apply to your quality issue. It is always useful to discuss the advantages and disadvantages of your chosen tool and these can be found in the literature.

• If you choose to use SWOT, then use a table to present your analysis and use bullet points.

• You must include your tool (e.g. Ishikawa) in the main body of your essay, so do not put this in the appendix. Work in the appendix does not count towards the mark.

• There is no need to discuss each point in your table or fishbone diagram. I suggest you include one paragraph that summarises the key causes that have led to your quality issue.

• If you cannot draw the fishbone on the computer then do by hand. However, you can download a 'fish' from Google.
Tables and diagrams do not count in the word count.

Please note that using a table or diagram as suggested above allows the discussion on the strategies to be analysed in more depth.

This in depth discussion is important for this assignment and demonstrates learning and understanding, which is likely to result in higher marks.

After the analysis:

• Briefly discuss total quality management and link to clinical governance - this discussion could be included in the introduction rather than here. This is not a lengthy discussion.

• You could briefly discuss change management and use Lewin's force-field analysis to prioritise your issues from the analysis. If you do choose to use Lewin discuss this after the analysis section. You can then use strategies / theories from clinical governance to reduce the resistors and / or strengthen the drivers.

Strategies:

• Briefly discuss the importance of standards and LIST some SMART standards. You could present a standard with each theory OR present all your standards at the beginning of this section. Link the discussion on standards to audit (briefly).