Clinical Governance Measuring Health System

Question: Discuss about the Clinical Governance for Measuring Health System. Answer: The move to foster quality health in New Zealand among nurses has been implemented in the recent years. An element such as clinical leadership has heavily been invested in by the government and non-governmental organisations so that the objective of ensuring constant quality is upheld in the country. There are various strengths associated with it, like accountability, professional development, quality assurance, fostering teamwork, improved health outcomes, collaboration among health workers, improved health resource management, among others. However, there are weaknesses like lack of enough information, insufficient resources, and mismanagement, inadequate support from the government and non-governmental organisations, and many others that will be discussed in this paper. Nursing, as a profession, is instrumental in maintaining and developing quality. It is the area of personal experience that integrated clinical governance, thus resulting in the identification of the strengths and weaknesses in this discussion. The New Zealand nursing council regulates the competencies and standards for registration, which always ensures competent and safe care of the New Zealand's public. Some of the important issues in the guideline includes Treaty of Waitangi, cultural safety, and Maori health. Among the specific traits of nurses are the promotion, optimisation, and protection of abilities and health, preventing injuries and illness, and alleviating the suffering of people from all walks of life. These traits are ensured through ethical behaviour, proper nursing education, health promotion and other vital functions ("Scopes of practice / Nurses / Home - Nursing Council of New Zealand," 2016). The New Zealand Nursing Council provides the vividly established scopes of practice for enrolled, registered and practitioner nurses. The values underpin practice in nursing and form the basis for the philosophy of nursing formulation. Among the values is upholding needs, rights and benefits of the patient in making decisions, no discrimination, maintaining a therapeutic relationship, advocacy for patient's, family's and community's rights, supervision of juniors and proper delegation, and a combination of science and art in the provision of care. Furthermore, the practice has to be based on the professional conduct principles that are provided in the updated professional ethics and code of conduct for registered midwives and nurses in New Zealand. Again, the scope of practice grows and changes as proficiency develops and factors such as the nurses education, collaboration in practice, the setting of practice, patient safety, outcomes of care and needs of the patient. In any organisation, teamwork is paramount, and nurses collaborate with other health practitioners like doctors, laboratory technicians, nutritionists, consultants, surgeons, and physiotherapists. Nurses are always interacting with patients and therefore, they note some specific issues that can help in the overall recuperation ("Scopes of practice / Nurses / Home - Nursing Council of New Zealand," 2016). For instance, a nurse has thrice chances of noting that a client is allergic to a given drug than a physician or a pharmacist. In this case, they may recommend halting the drug immediately and introducing an alternative one. In a nutshell, collaboration among the health practitioners is essential in ensuring positive patient outcomes and quality care. Nurses have a cordial relationship with their colleagues and counterparts. Definitions Clinical governance It is a structure through which organisations have to safeguard standards of care that are high and to be accountable for continuously advancing and improving the services they render to the public by providing an environment through which clinical care shall excel. In clinical practice, governance means that each team member must understand their role in the provision of quality care, improvement of care has to be realised through the most appropriate method, identification of issues that need advancement and planning and monitoring their development. Furthermore, being accountable for the care one provides, management of the personal practice and the ability to demonstrate to others that the care given is of quality. All these parameters have to be supplemented by credible leadership because it determines the provision of resources, education and other vital things (Gottwald Lansdown, 2014). Clinical governance empowers, improves and assures quality by the entire nursing profession. It is because nurses provide primary care, therefore upholding the governance guidelines improves care and promotes patient healing thus shortening the time of hospitalisation, early resumption of regular duties among other benefits (Reddy, 2013). Contemporary healthcare in New Zealand The modern health in New Zealand involves the utilisation of technology, improved training facilities, developed nursing practice, increased government funding among other developments (Arnaiz, 2016). Modern machines for dialysis, cardiac support and others are improved to meet public support. Intensive care units and general hospitals have also developed. Again, the use of quality strategies like clinical governance has helped New Zealand's contemporary health care. From 1983, the health sector of New Zealand has gone through four transformations. Each of them had different organisations meant for provision of care and funding. The Area Health Boards (AHBs) were between 1983 and 1993, Crown Health Enterprises (CHEs) and Regional Health Authorities (RHAs) were between 1993 and 1997 (Khan, 2014). Subsequently, Hospital and Health Services (HHSs) and Health Funding Authority (HFA) operated between 1997 and 2001, and finally, District Health Boards (DHBs) which came from 2001 ("Democratic Governance Health: Hospitals, Politics and Health Policy in New Zealand", 2013). The health demand in New Zealand is massive considering that most of the population consists of the senior citizens. These government policies have evolved in a bid to meet the high population needs of health care (Chan, 2013). Strengths of Clinical Governance. Clinical governance promotes quality in care. During the personal nursing practice, clinical leadership through the facilitation of models such as team nursing improved understanding of the patients condition and identification of the best interventions of care. Most of the patients aired their satisfaction with the facilitys means of providing nursing and medical attention. Other models like primary nursing were also utilised. Again, the nurse in charge always took the lead role in dispensing quality care. Clinical governance percolated from the top facility leadership to the ground; this saw that the other health practitioners like doctors and pharmacists upheld quality (Ashton, 2015). It improves the effectiveness of the health interventions. In a person's health, how effective medical attention is determines the health outcome. Clinical governance advocates for the quality prescription, administration of the right drugs, to the right patients and the right dosages. Aside from medical care, psychological and physical management such as bed bath and Cognitive Behaviour Therapy (CBT) are also enhanced (Butcher, 2015). During my experience, a nurse, a nutritionist, a physiotherapist, a mechanical technician, a doctor, interns, and consultants were all present during a ward round. This move ensured that there could be maximum contributions towards the patient's health. Clinical governance provides continuous health education and development. Most practitioners who involve in governance seek further education because there is constant training by organisations such as government on quality clinical governance. During practice, there was a hospital policy, established through governance that sponsored outstanding practitioners for further studies. The initiative saw a healthy competition among practitioners and improved their quality of education. The in charges went for health management masters degrees and other fields like ICU and renal nursing, medical and surgical nursing among others. It has significantly improved the education for practitioners and personal development. Advancement of knowledge among health workers is the hallmark of superb health in any nation because experienced practitioners are efficient. It improves research and upholds evidence-based practice (EBP). Clinical governance has elements like leadership, evidence-based decision making, cooperation among clinicians, career development, and others. These features are improved through research. Also, EBP has to utilise research and it is advocated for in clinical governance. For continuity of any profession, research must be integrated, and health care is one of the prominent areas utilising it. During practice, there was a mandatory participation in research, for instance, the collaboration between the Medical Research Institute of New Zealand and the hospital on the commonest lifestyle behaviours in Wellington that gradually led to the development of cardiac problems (Gauld, 2013). Weaknesses of Clinical Governance. Among the most prominent weakness of clinical governance witnessed during the clinical practice is the lack of motivation and a poor attitude towards the strategy by the health practitioners. Since the approach was recently introduced in New Zealand, most health institutions prefer utilizing traditional health delivery methods that most of their staff understand well. The health workers also deem the approach, so involving and tedious thus shunning away. For instance, during the personal nursing practice, as the workers, it took much time to prove the importance of the system to colleagues and even the hospital management. Another challenge was the increased criticism of the method since it was new for adoption in the health system (Gottwald Lansdown, 2014). Clinical governance is very expensive. Most of the institutions in New Zealand were reluctant to use this approach because it needed much investment in research and supplemental activities like transport, accommodation among others. For instance, when an institution sponsors an individual for further education, and seminars of clinical governance spends a lot of money. Therefore, the method can only be feasible in well-established settings and discriminates upcoming hospitals and nursing homes. Even the government has a hard time to ensure clinical governance is uniform in the health system. Revenue projected to the sector is insufficient because full realisation demands much money that can lead to suspension of other important tasks like procurement of drugs and other supplies in health institutions (Gauld Horsburgh, 2015). Again, the approach is time-consuming. For the effective outcome of the process to be achieved, a long wait is to be endured. In the initial stages of implementation of the approach in the New Zealand's contemporary health care environment, positive results have not been seen instead losses and frustrations of massive investment in the project. This finding has orchestrated negative reception of clinical governance by institutions, individuals, the government and non-governmental agencies. Additionally, it requires a bureaucratic process in implementation from the senior health workers to the junior ones. Most of the practitioners do not understand the requirements of clinical governance because it has a sophisticated content that needs vivid scrutiny and study (Gauld Horsburgh, 2015). Therefore, if they engage in the approach, its hard for them to exhibit the consciousness of its importance, and ultimately give up. Conclusion It has been found that clinical governance is vital in maintaining quality considering the numerous strengths that have been discussed in this paper. The advantages include the promotion of quality care, improvement of the effectiveness of health interventions, ensuring continuous health education and individual development, and improvement of research. Despite the strengths, there are weaknesses that have been explored as well. They include reduced motivation and attitude by the workers to this approach; it is expensive for most of the institutions and individuals in New Zealand, bureaucratic, time-consuming and it is hard to understand especially for the novice practitioners ("Health Promotion: Ideology, discipline, and specialism", 2015). Recommendations Considering the findings in this discussion, the following recommendations have been proposed; The government should increase funding to health institutions to foster clinical governance. Health practitioners to embrace a personal urge for evidence-based practice (EBP). The government to enact policies and plans for motivating health leaders to embrace clinical governance. New Zealand nursing council to promote governance in nursing education. Political interference in health care to be abolished and proper legislations put in place. Seminars and training programs to be intensified in health institutions. A campaign for the change of attitude towards clinical governance to be initiated. An all-rounded support system to be identified by experts in support of the strategy. Public cooperation to be championed so that clinical governance gets back up. Constitutional amendments should be done in a bid to enable nurses and other health workers perform some extra duties and mandatory upgrading of education. Hospital policies to be proposed requiring every hospital to adopt clinical governance as their way of operation. 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