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A robust clinical review process: the catalyst for clinical governance in an Australian tertiary hospital
Author(s) -
Mitchell Imogen A,
Antoniou Bobby,
Gosper Judith L,
Mollett John,
Hurwitz Mark D,
Bessell Tracey L
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb02120.x
Subject(s) - multidisciplinary approach , clinical governance , medicine , adverse effect , corporate governance , family medicine , health care , intensive care medicine , business , political science , finance , law
Objective: To determine if a robust clinical review process can influence an organisation's response to adverse patient outcomes. Design and setting: Retrospective analysis of the activity and outputs of the Clinical Review Committee (CRC) of a university‐affiliated tertiary hospital from 1 September 2002 to 30 June 2006. Main outcome measures: Engagement of clinicians (number on CRC, number interviewed for the clinical review process, number of specific referrals from clinicians); and numbers of cases reviewed, system issues identified, recommendations made to the hospital board, and ensuing actions. Results: A multidisciplinary CRC with 34 members established a robust clinical review process and identified 5925 cases for initial case review. Of these, 2776 (46.8%) fulfilled one or more of the specified criteria for adverse events and progressed to detailed review; 342 of these (12.3%) were classed as serious or major. A total of 317 staff (11%) were interviewed, and 881 system issues were identified, resulting in 98 specific recommendations being made to the Clinical Board and implementation of 81 practice changes (including seven hospital‐wide projects) to improve patient care. Conclusion: A robust, multidisciplinary clinical review process with strong links to managers and policymakers can influence an organisation's response to adverse patient outcomes and underpin a clinical governance framework.