Clinical Governance overview

Clinical Governance overview A framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care can flourish (1) The term Clinical Governance (CG) was first introduced by the Labour government and underpinned by a statutory duty of quality set out in the Health Act 1999.The new government established for the first time a national framework, within which the NHS at a local level, can work towards realising consistent and systematic improvements in the quality of patient of care. Clinical Governance places a clear responsibility upon NHS organisations for the delivery and continuous improvement of patient care. In practice this means implementing principles that will result in a high quality of care for patients by a highly motivated and qualified workforce. The introduction of the contractual framework of community pharmacy in April 2005 laid out specific requirements for CG consisting of principles which were to be integrated into each pharmacy by a nominated clinical governance lead.(2) The contractual framework makes clear the role of community pharmacy and its contribution to the achievement of the targets for the health sector. Primary Care Trusts will support pharmacy contractors in implementing the new framework and monitoring compliance was only to begin in October 2005. For the introduction of CG to be successful it is essential that there is of mutual benefit to community pharmacy and the rest of the local NHS, while improving quality service to patients. Clinical Governance is composed of seven principle elements, Education, Clinical audit, Clinical Effectiveness, Risk Management, Research and Development, and Openness. The principles above are all extremely important in their contribution to clinical governance and I will discuss in detail some of the above in this essay. As part of the CG requirements, pharmacies have to participate in a clinical audit of their services and have the necessary arrangements in place to verify the quality of advice given to patients. Clinical audit involves the pharmacist and their staff participating in one practice based audit and one PCO determined multidisciplinary audit each year. Patient involvement entails the public to complete Community Pharmacy Patient Questionnaire to express their level of satisfaction at the services provided by their local community pharmacy. The pharmacies should review the surveys and consider changes to improve their services. Risk management ensures pharmacists provide sufficient evidence of recording, reporting, monitoring, analysing and learning from patient safety incidents. Clinical effectiveness programmes ensure the correct operating procedures are in place for the management of repeat NHS prescriptions, medicines use reviews and standard operating procedures. Staffing and staff management ensure that the people operating within the pharmacy have all the necessary training skills related to their role in the pharmacy and up to date with the legality issues surrounding confidentiality procedures, health and safety issues etc. Pharmacy operators must also ensure that there is an induction and written operating procedures for locums, who will be undertake the role of responsible pharmacist at different pharmacy premises. Pharmacists must also demonstrate their commitment to continuing professional development (CPD) through a CPD record, acquire information via up to date reference sources and comply with regulations. (3) Pharmacists have been implementing many of the aspects of CG in their roles as front line carers for patients on a day to day basis for many years. The structures put in place for the development of a CG framework; build upon the existing strengths possessed by pharmacys and highlights areas where improvements can be made. For CG to be successful and for processes to become embedded in pharmacies, pharmacists must be able to recognise the compelling nature of it outcomes. They should be clear on the intended benefits and understand that CG is an opportunity for them as individuals to adapt to change, generate new knowledge and continue to improve in their professional performance. (4) Clinical Governance activities can raise awareness of learning needs for example through audit and also for the continuing development of the services they provide within their organisation to provide the best form of patient care possible. Adverse incident reporting is an important element of CG but in general incident reporting to external bodies is at an early stage in community pharmacy and will require considerable culture change. The development of the No blame culture is essential and is important for pharmacists to realise that incidents and mistakes do occur but as long as the necessary procedures are taken to prevent dispensing errors and near misses through examination of these errors in an objective way to prevent the same problems happening over and over again. (5) Clinical effectiveness is made up of a range of quality improvement activities and initiatives including evidence, guidelines and standards to identify and implement best practice. Clinical Governance invites pharmacists and their working team to perform at very high professional level, which improves the quality of patient care and helps improve patient trust. This generates a feel good factor for the pharmacist and his team, in the services they are providing to the public and gives them the confidence and makes them better equipped for issues which present themselves in their pharmacies. Risk management is key part in CG, as the safety of patients is the main priority for all the healthcare team. The reporting of dispensing errors to an external board could minimize the risks of potential hazardous situations caused by dispensing errors, by effectively setting motions in place to reduce or remove risks. The principles of CG applies to all practitioners, including community pharmac ists, who have an important contribution to make to the development of a coherent strategy for assuring and improving the service provision across the local health community. (6) This involves working and communicating as a multi-disciplined team across primary care but also between primary and secondary care, to improve the overall quality of patient care. Clinical Governance also has systems in place to identify poorly performing pharmacists and provides retraining and other support at an early stage for pharmacists but the onus is on them to acquire the necessary skills to act as professional pharmacists and build on their existing knowledge. There is no doubt that Clinical Governance is a positive driving force behind improving patient care but there are questions of how practical it can be in the day to day running of busy pharmacies. Many pharmacists especially the older generation have found it particularly difficult to come to terms with the massive impact of paperwork associated with clinical governance and finding time to implement everything is a problem and many feel that time filling out forms would be better fulfilled advising patients. Cost is another problem, training staff to be effective in CG and employing locums, buying CG packs and having to close the pharmacy to attend PCT meetings are certainly not cheap. There are numerous other problems which could be mentioned which pharmacists find challenging and wrong with CG. In conclusion, the concept behind Clinical Governance has been put forward to undoubtedly benefit the entire health system. It is therefore important that systems are in place to maintain a high standard of clinical care. Pharmacists have been at the forefront of patient care and have been providing dependable services to the community for many years. The system of CG brings together all the elements which seek to promote quality care and the challenge of it shouldnt be underestimated. The cultures involved will need to be understood and greater sensitivity shown to pharmacists to help them review and justify their performance. Many pharmacists are apprehensive about CG and feel the changes involved could be an unnecessary intrusion and many will only be won over when they can see that its in their interest and that of their patients. (Word Count 1196) Clinical Governance; Quality in the new NHS (HSC 1999/065) Department of Health, London, 1999 Department of health, 28/4/05 Implementing the new Community Pharmacy Contractual Framework www.psnc.org.uk/pages/essential_service_clinical_governance.html PSNC, Essential service 8- Clinical Governance Requirements in the New Community Pharmacy Contractual Framework Continuing Professional Development: Quality in the new NHS. (HSC 1999/154) Department of Health, London, 1999. Doing Less Harm. Department of Health 7 national Patient Safety Agency, London, 2001. Pharmacy in the Future-Implementing the NHS plan. Department of Health, London,2005

Ducati Paper

Margaret DeWitt Ducati Turnaround The turnaround success of Ducati was the direct result of Federico Minoli’s implementation of a differentiation strategy. As a company that was heading towards bankruptcy, Ducati was saved and revamped by Minoli’s specific vision for the company that were precisely presented in an extremely realistic manner. These goals for the company included double-digit growth for Ducati and equaling Harley-Davidson’s profit level. After reading the success of this turnaround, one point that I found very interesting and contributed to the company’s success is Minoli’s staffing method for Ducati.Not only did he strive to acquire intelligent and qualified workers, but also he emphasized passion and creativity in the workplace. The article refers to this â€Å"structured chaos† as the primary source of creativity. Another unique staffing method using by Minoli was that none of the new staff had previous experience in the mot orcycle industry. According to Minoli, even though they had no previous experience they were still capable of becoming passionate about this company and its products and would therefore be a successful management team.It is apparent Minoli views everyone involved in the production of Ducati’s products as a key success factor in its turnaround. In choosing the right strategy for Ducati, Minoli debated between standardizing the engine, which would result in better efficiency, or to remain true to what the motorcycle represented. He wanted the brand name to appeal not only to extreme motorcycle riders but also so other segments of buyers. By implementing a differentiation strategy, Minoli was able to position Ducati in a way that showcased its uniqueness as a motorcycle.It was also a way to separate it from other motorcycle companies such as Harley-Davidson and Honda. The specific features of their product are so unique to the brand name that it would be difficult and expensive for competitors to try to mimic. The company has moved from a â€Å"product-centered† company, as many of its competitors are categorized as, to an â€Å"experience-centered† company. It is not only focused on producing and selling motorcycles, but also focused on selling the lifestyle benefits of owning a Ducati motorcycle and being part of the Ducati organization.This was a smart move on behalf of Ducati for two main reasons: to increase sales due to product uniqueness and the building of customer loyalty through repeat customers. As customers buy into a lifestyle, they are more likely to continue to purchase that product. Two of the factors that Ducati possess that contributes to its differentiation from other companies are its top engineering team and increased investment in research and development.As a result of the company ‘s product development and research and development sectors become more open structures, there have been tremendous cost savings and qu icker product launches. Also, as technology is a growing asset to the motorcycle industry, Ducati’s success can be a direct result of the expertise taken from their racing division. Another attribute that supports the differentiation strategy of Ducati motorcycles is the creation of the â€Å"World of Ducati† in addition to â€Å"Ducati Stores†.Through the several activities including racing, advertising in specialized magazines, the Ducati museum, Ducati owners clubs, and Ducati special events, the company successfully built an atmosphere unique to Ducati that customers can buy into. This not only creates brand loyalty for the product but also gives the owners of Ducati motorcycles the feeling that they have something special or unique that cannot be purchased elsewhere. By using the differentiation strategy to position itself as â€Å"the sport bike company†, Ducati, in my opinion, will be able to sustain its position in the market.By strictly competing in the sport bike segment of the market, Ducati makes it difficult for threats by all other competition. Even though companies such as Honda and Harley- Davidson also produce motorcycles, they are not specialized in sport bikes and do not sell â€Å"the lifestyle† of having their particular product. I think by sticking to one specialty, Ducati has more power over its customers than all other competing companies. This does not however eliminate rivalries between companies altogether.Even though Ducati may have the advantage of differentiation, this particular industry is continuing to grow and with that comes more competition for customers. I think that one tradeoff that Ducati has to face is staying focused on the sport bike segment rather than branching off into other segments of the market. Even though branching into other product lines may be beneficial in the short-term aspect, I think that by sticking to what they have already successfully built and expanding their curr ent market segment will eventually lead to higher long-term profitability.They could possibly achieve this by expanding distribution. Ducati can offer its product and all of the benefits that come with purchasing one in more locations. The only thing Ducati should be careful of is that they do not over-expand. They want to make their product more available for new customers but not in a way that makes the lifestyle of owning a Ducati as â€Å"normal† as owning maybe a Harley-Davidson. They need to make sure they still have the advantage of having that differentiation factor that sets them apart from the competition.Overall, Minoli’s implementation of the differentiation strategy was critical to the turnaround of Ducati. By focusing in on what they are good at and building a brand upon those elements, this company was able to go from almost bankruptcy to an extremely profitable company in the sports bike industry. Also, by distinguishing itself from just a motorcycle co mpany to an â€Å"experienced-centered† company that offers customers a particular lifestyle and the chance to be part of a community also plays a role in the success of its turnaround.This important element brought in new customers and increased the likelihood of repeat customers. Even though competition in the motorcycle industry is tough and continues to get even more competitive, Ducati will continue to set itself apart from the rest with it’s ability to sell not only a sports bike but a product lifestyle as well. I think that if Ducati continues to successfully use its resources in the future, they will sustain their share in the market and have the opportunity to even expand it.

Family and Religion Influence on People Essay - 1602 Words

Family and Religion: Influence on People If you asked people to describe their families, some would describe single-household families, some would describe stepfamilies, some would describe gay or lesbian or adoptive families and many would describe divorced families. The word family has become a diverse institution it is very difficult to give it a meaning. In a wide sense especially in the biological sciences the term family refers to a group of individual beings linked by blood relations, having a whole line of ancestors and descendants. Aristotle defines the family as a community designed to attend to the basic and permanent needs of the household such as clothing food and shelter. In the past decades the traditional family†¦show more content†¦Before industrialization, work was done from home. But with industrialization, paid labor was done mainly away from home in marketplaces and factories. Families continue to be influenced by social structural forces. Especially f or some families that particularly rely on all the members of the household to work to meet the economical needs of the household. The ability to create and sustain nuclear family is linked to the political, economic and racial organization of society. How do new family forms emerge? Is the family a source of stability or change in society? These are types of questions sociological theories of the family. Functionalist Theory defines family as filling particular social needs, these social needs include providing care for family member, giving psychological support and emotional security to individuals and regulating in sexual activity to reproduce new members. Families exist mainly to meet these needs and ensure consent of values in society. In the functionalist framework, family is gestated as a beneficial exchange. The women receive protection, sexual support and economic support. 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The Supreme Court Of Virginia - 3442 Words

In any legal system, there is a notion that the chief end to be achieved is justice. Clearly no one would advocate for an unjust legal system, but what if the clear distinction between just and unjust is not so clear? What if there are diametrically opposed moral principles supporting competing arguments? On three occasions, the Supreme Court of Virginia has declined ruling on whether the relationship with an assailant s wife deprives a defendant of the right to self-defense. The Supreme Court of Virginia should deny a defendant the right to claim self-defense when the following elements are present: (1) the defendant is charged with murder, (2) the defendant was in the act of sexual intimacy with the victim’s spouse, (3) the victim was†¦show more content†¦It is in the public’s interest to maintain a predictable standard of acceptable behavior. Without such a standard, society will fall into chaos. There are two traditional, primary means for integrating moral reasoning into the analysis of criminal law. The first is requiring a defendant to have a culpable mental state for most crimes. The second is the doctrine of affirmative defenses. There are two types of Affirmative defenses: justifications and excuses. In effect, if a defendant can establish a defense, the defendant should be acquitted because society believes he took the right or at least a tolerable action. Excuses, invoke the notion that while what the defendant did was not justified, the defendant â€Å"should not be held accountable for his wrongdoing because he is not to blame for it.† Despite the fact that the criminal law is essentially a moral enterprise, the legally-trained actors in the criminal justice system rarely explicitly examine exactly what moral principles the system is enforcing. One reason for the absence of moral analysis is that most lawyers are not trained in moral philosophy. Generally, legal education has never seriously attempted to incorporate moral principles into instruction.† Another explanation for the absence in moral reasoning in the criminal law is that there is no need for any deep moral debate concerning the right or wrong of