Abstract
This paper aims at proposing validated principles to underpin clinical management as a means to transform healthcare for integrated healthcare systems. The starting point was the conception of clinical management based on structuring elements that do not separate management, care and education. The authors' proposal was submitted to specialists so that a consensus could be reached. At the end of the process, the following principles of clinical management were presented: (1) Focus on health needs and comprehensive care, (2) Quality and safety in healthcare, (3) Articulation and legitimation of different health practices and types of knowledge to face health problems, (4) Power sharing and co-accountability among managers, health professionals and citizens in healthcare production; (5) Education of people and organizations; (6) Focus on outcomes that add value to health and life; (7) Transparency and accountability regarding collective interests. It is concluded that the principles of clinical management express connections that shed new light on management, healthcare, and education in integrated healthcare systems, requiring critical awareness in relation to the simultaneity of "permanence" and change in practices.
Highlights
The creation of integrated health systems gained strength in the second half of the 20th century, with the emergence of the National Health Service - NHS1
One of the initiatives with a systemic scope is that of clinical governance, which emerged in the 1990s in the sphere of the NHS
Clinical governance has influenced other health systems to define and implement policies and guidelines aiming to improve the quality of the clinic, tackling, among other factors, variability in care provision
Summary
The creation of integrated health systems gained strength in the second half of the 20th century, with the emergence of the National Health Service - NHS1. The Brazilian National Health System (SUS) was influenced by this model, whose most relevant dimensions involved changes in financing, coverage, access to services, and in the comprehensiveness of care. In this field, one of the initiatives with a systemic scope is that of clinical governance, which emerged in the 1990s in the sphere of the NHS. One of the initiatives with a systemic scope is that of clinical governance, which emerged in the 1990s in the sphere of the NHS Focusing on quality, it was defined as a system through which health organizations commit to continually improving their services and to maintaining high standards of care, creating an adequate environment for clinical excellence[2]. In Australia, publications about clinical governance focus on four dimensions: clinical performance and assessment; professional development; risk and safety; values and involvement of patients/users[2]
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