Patient safety and clinical governance

Abstract

This chapter builds on the original work done by Elizabeth Haxby and Susanna Walker in the 2nd edition of the ESC Textbook of Critical and Acute Cardiac Care. Clinical governance appeared as a concept in the UK in the late 1990s following scandals in which patients were harmed as a consequence of health care failures. Further international research estimates that one in ten inpatients suffer harm as a result of their health care, leading to death in some cases. Clinical governance is a framework centred around domains of patient safety, clinical effectiveness, and patient experience, underpinned by effective teamwork, leadership, and communication. Its aim is to ensure consistent, reliable, high-quality care delivered by competent individuals in a safe environment. Understanding why things go wrong in health care is key to finding solutions to ensure patient safety. Health care is an increasingly high-risk activity at organizational, departmental, and individual levels, and hazard identification and management are important. Recent recognition of human factors as contributing to many adverse events has facilitated the exploration of how health care professionals function within the context of a high-pressure, unpredictable environment.