Editorial

Citation

Gillies, A. and Harrop, N. (2013), "Editorial", Clinical Governance: An International Journal, Vol. 18 No. 3. https://doi.org/10.1108/cgij.2013.24818caa.001

Editorial

Article Type: Editorial From: Clinical Governance: An International Journal, Volume 18, Issue 3

Since taking over the editorship of Clinical Governance: An International Journal, one of our goals has been to ensure that the work represented truly reflects the diversity of perspectives found in different national contexts. The terms “clinical governance” is a term that originates from the UK, but the issues it covers are truly global in nature. All across the world, the health care system is facing increased demand and in times of global austerity reduced resources to meet this demand.

Therefore the international diversity of this issue is source of great satisfaction, and the opportunities for inter-national learning are great.

In his North American Perspectives, David Birnbaum highlights the challenges faced in quality assuring health information on the worldwide web: a challenge in all our health economies. Often problems arise from potential conflicts of interest. In a largely private health care system, such conflicts may arise from the need to maximise profit. In a public system, there may be a perceived or real conflict with rationing of health care.

The article by Khayatzadeh-Mahani provides a number of different perspectives. For some the key lessons may be around the experience of health care delivery in a developing country: for others, the key characteristics may arise from the centrally planned nature of the system.

The article from Brown about the Solomon Islands reminds us that national contexts can vary enormously, thus the Solomon Islands also represents a developing country context, but each context has its own specific cultural, geopolitical and physical characteristics. This paper highlights the need for good general governance to protect the limited resources available, a lesson I saw for myself on a recent visit to West Africa. At the same time, the observation cited in this paper that “Redman-MacLaren (2010b) notes that in low-income countries, such as Solomon Islands, research in health needs to be empowered by local direction for health” mirrors the trend in England towards the localisation of health agendas through the new Clinical Commissioning Groups.

Muslim’s paper highlights the importance of patient satisfaction. While there will be aspects of what matters to patients which are different in the Malaysian context, many of the lessons which may be drawn are universal. The use of service quality models such as SERVQUAL may be seen as challenging in systems driven by a public service ethos, and yet we know that patient and professional perspectives of quality may differ, and the highly political nature of modern health care means that hospitals and other providers are increasingly measured by their patients’ view of them even where the idea of “competitive advantage” may be an anathema.

The role of information in improving and measuring the quality of care is a key concern of your editors. At the same time, many clinicians feel they are faced with too much data and not enough information. The concept of a dashboard evaluated by Sharmistha is a therefore a valuable one. The scope and content of a dashboard should be determined by local need and context, but the principle of focusing clinician attention on what really matters is valid in any sector in any national context.

While the importance of primary care has been universally acknowledged by the World Health Organisation among others, its implementation varies hugely from country to country. However, whatever the setting, as Donnellon states “The quality of the consultation is central to the patient experience.” The final paper has valuable lessons in how to evaluate this aspect of the patient experience which will we believe be valuable in any context.

In providing an international forum for the sharing of knowledge about clinical governance, we believe that we can learn much from different contexts, not by slavishly saying, “What worked over there must be good for over here” but rather by encouraging our readers to reflect on other people’s research and experience and to ask themselves what lessons are there for their own work and context. If we achieve that with this issue and others, then we will be providing a valuable service to the clinical and academic community, and above all to patients and the public.

Alan Gillies, Nick Harrop