The essay begins with a section devoted to the analysis of the term governance, which highlights how it has to do with a model of a polycentric system of decision making, "from bottom", with strong characterization negotiation. This is particularly relevant as regards the clinical governance companies, such as those relating to the NHS National Health Service, whose mission is the delivery of services to citizens. It follows that sustainability should be related to the relationship between available resources - service quality - quality of life of all stakeholders. In the second paragraph, highlights the strategic importance for the implementation of strategies for clinical governance, human capital and social capital, and put forward proposals aimed at enhancing their value as a commitment to build trust and cooperative relations based on shared moral principles (responsible, caring, respect for autonomy, etc..), development of skills beginning with the ethical competence (consisting in elaboration of moral judgment and give him reasons) as a core competence. In the third paragraph, is pointed out that for clinical governance we should mean a strategic vision and practice that concerns: the responsibility with the expected results, the involvement of different professionalities and their participation in decision making, the definition of clear and explicit objectives to assess the adequacy of the actions, the quality of services. Among its specific objectives can be listed: development of research, training of personnel, standardization of criteria for clinical practice, clinical audit, assessment of user satisfaction in service provision, promotion of interprofessional dimension; economical use of resources; risk management, involvement of users and various professionals working in the NHS. In the fourth section, we show how strategies can be implemented strategies of clinical governance by combining instances of ethics of rights with the ethics of care. This involves a management system based on a culture of mutual learning (learning with) of the all stakeholders that is embodied in paths of cooperation, attention to biographies and contexts. This is a true process of democratization of medicine. Also the affordability issue can not be reduced to accounting. The equal savings as principle of sustainability, requires choices involving moral accountability and public justification of the same, in consideration of their social impact on quality of life of citizens as stockholder, as taxpayers, and as stakeholders as users. The fifth paragraph, shows how a practice of clinical governance able to combines rights and care is possible by referring to the model of the Company Stakeholder Responsibility. This involves: 1. Condidering fundamental all the forms of value creation and, in particular, the human and social capital; 2. Creating value for stakeholders and fulfill the responsibility towards them, 3. The non-separation of ethics in economic management; 4. The attribution of value to the quality of life of stakeholders. The sixth and last section, analyze the implications of the model of clinical governance, which has been established, in the organization and management of a cancer ward demonstrating how it can help to ensure that, even in sickness, we can have a decent quality of life and not lose hope, as long as we can, in its significance for us and for those who, for various reasons, relate with us.

Clinical governance: l’organizzazione della sanità a sostegno della qualità della vita

MANTI, FRANCO
2010-01-01

Abstract

The essay begins with a section devoted to the analysis of the term governance, which highlights how it has to do with a model of a polycentric system of decision making, "from bottom", with strong characterization negotiation. This is particularly relevant as regards the clinical governance companies, such as those relating to the NHS National Health Service, whose mission is the delivery of services to citizens. It follows that sustainability should be related to the relationship between available resources - service quality - quality of life of all stakeholders. In the second paragraph, highlights the strategic importance for the implementation of strategies for clinical governance, human capital and social capital, and put forward proposals aimed at enhancing their value as a commitment to build trust and cooperative relations based on shared moral principles (responsible, caring, respect for autonomy, etc..), development of skills beginning with the ethical competence (consisting in elaboration of moral judgment and give him reasons) as a core competence. In the third paragraph, is pointed out that for clinical governance we should mean a strategic vision and practice that concerns: the responsibility with the expected results, the involvement of different professionalities and their participation in decision making, the definition of clear and explicit objectives to assess the adequacy of the actions, the quality of services. Among its specific objectives can be listed: development of research, training of personnel, standardization of criteria for clinical practice, clinical audit, assessment of user satisfaction in service provision, promotion of interprofessional dimension; economical use of resources; risk management, involvement of users and various professionals working in the NHS. In the fourth section, we show how strategies can be implemented strategies of clinical governance by combining instances of ethics of rights with the ethics of care. This involves a management system based on a culture of mutual learning (learning with) of the all stakeholders that is embodied in paths of cooperation, attention to biographies and contexts. This is a true process of democratization of medicine. Also the affordability issue can not be reduced to accounting. The equal savings as principle of sustainability, requires choices involving moral accountability and public justification of the same, in consideration of their social impact on quality of life of citizens as stockholder, as taxpayers, and as stakeholders as users. The fifth paragraph, shows how a practice of clinical governance able to combines rights and care is possible by referring to the model of the Company Stakeholder Responsibility. This involves: 1. Condidering fundamental all the forms of value creation and, in particular, the human and social capital; 2. Creating value for stakeholders and fulfill the responsibility towards them, 3. The non-separation of ethics in economic management; 4. The attribution of value to the quality of life of stakeholders. The sixth and last section, analyze the implications of the model of clinical governance, which has been established, in the organization and management of a cancer ward demonstrating how it can help to ensure that, even in sickness, we can have a decent quality of life and not lose hope, as long as we can, in its significance for us and for those who, for various reasons, relate with us.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11567/235622
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