Some readers may be interested in a paper from a 2007 issue of Clinician in Management (now the International Journal of Clinical Leadership) that describes a practical governance framework that attempts to ensure that obstacles are not put in the way of progressing with innovative clinical quality improvement projects.
With the advent of evidence-based practice and the need to demonstrate the effectiveness and efficiency of service provision, healthcare practitioners find themselves having to comply with increasingly complex governance requirements surrounding the collection of data within an NHS organisation. A number of authors have suggested that the administrative burden that accompanies clinical effectiveness activities could in itself stifle innovations in practice. Putting obstacles in the way of ‘quality improvement’ projects could lead to poor practice and a potential reduction in the much needed service developments. This anxiety has to be balanced by the need to fully comply with research governance processes and ensure ethical considerations apply to both research activities and service evaluations.
Debate exists about the differentiation between such activities, whether the activity is research requiring full governance, audit or service development improvement projects. This paper describes the work undertaken at Sheffield Teaching Hospitals NHS Foundation Trust to develop a framework for classification of data collection activities, by using ‘simple rules’ and subsequent ‘rule in questions’. The paper discusses how this framework ensures that appropriate ethical considerations take place for all activities and how an NHS organisation can reduce the risk of contravening research governance and local clinical governance requirements whilst still encouraging quality improvement projects.
The full paper can be purchased here.