PubMed · 14727778
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Harold S Luft. 2003. Special issues, special sections--special consideration?. https://doi.org/10.1111/j.1475-6773.2003.00183_2.x
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BACKGROUND: Clinical governance has been introduced into health care in the United Kingdom as a means to improve quality. At present there is no legal duty for commercial occupational providers to implement this model. AIM: This preliminary study examined how commercial occupational health providers had implemented clinical governance. METHODS: The senior clinical manager of commercial occupational health providers completed a questionnaire. RESULTS: Fourteen of 17 organizations asked to participate completed the survey. Most of these had implemented some form of clinical governance. Patient and public involvement was attributed the least importance of potential components of clinical governance. Organizations were more likely to have systems to address poor clinical performance than encourage excellent performance. CONCLUSIONS: Commercial occupational health providers have implemented clinical governance. Its focus appears to be avoidance of failures rather than clinical excellence and patients. However, further work is needed to explore this more fully.
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We propose cumulative meta-analysis as the procedure of completing a new meta-analysis at each successive wave in a research database. Two facets of cumulative knowledge are considered: the first, sufficiency, refers to whether the meta-analytic database adequately demonstrates that a public health intervention works. The second, stability, refers to the shifts over time in the accruing evidence about whether a public health intervention works. We used a hypothetical data set to develop the indicators of sufficiency and stability, and then applied them to existing, published datasets. Our discussion centers on the implications of the use of this procedure in evaluating public health interventions.