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Focus on

La Clinical Governance: una breve ma veridica storia [1]

DOI 10.23753/htafocus2014.01.005

Ottavio Davini
AOU “Città della Salute e della Scienza” di Torino


Clinical Governance is a system for improving the standard of clinical practice.
It was born in United Kingdom, after impressive scandals (Bristol Cardiosurgery, the case of multiple murder dr. Shipman, and others).
Clinical Governance was first described as “…the system through which NHS organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care, by creating an environment in which clinical excellence will flourish”.
This definition is intended to embody three key attributes: recognizably high standards of care, transparent responsibility and accountability for those standards, and a constant dynamic of improvement.
Thereafter Clinical Governance is an aggre-gation of service improvement processes that are regulated by a single ideology.
It includes different objectives and tools, like Education and Training, Clinical audit, Clinical effectiveness, Research and Development, Openness, Risk management, Information Management, Evidence Based Medicine, Health Technology Assessment.
In Italy the theme is politically ignored or misleading, but some regional health services are trying to adopt the Clinical Governance approach, although we must observe a wide inhomogeneity.


Key words: Clinical Governance, health technology assessment, appropriateness, clinical audit, evidence based medicine

[1] Parte di questo articolo è riadattata dal libro “Il prezzo della salute”, di Ottavio Davini, Nutrimenti Editore, Roma, 2013.

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