Why process controls?
In the white paper on clinical governance there is a curious switch in emphasis. In the introduction, where the aims of the government policy are discussed, the emphasis is on improving outcomes. But in the bulk of the white paper, on the practical measures for achieving this improvement, the focus becomes processes to be implemented. It is striking that so little attention is paid to outcomes, other than monitoring the successful implementation of procedures. For instance, in the chapter Monitoring quality Standards, the question How will the Commission for Health Improvement Help patients? is answered with statements on providing reassurance that effective systems are in place, working to reduce variations in services, providing feedback into the National Service Frameworks and monitoring of uptake of NICE guidance. [1] Thus, monitoring the success of process controls in improving the quality of outcome becomes a key issue. Currently the balance of evidence is in favour of guidelines
