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Clinical governance: the role of measures

James A Duffy, Elizabeth A Irvine

Traditionally outcome measures have been focused on targets and performance indicators. Setting targets does not alter performance and the use of such measures can lead people into making meeting the target the aim instead of changing the performance. This paper attempts to illustrate the problems that exist with the types of measures generally in use and also to show the alternatives. The authors would suggest that these alternatives are whole system measures that are derived from patient demand and reflect variation. Thesemeasures should drive improvement by producing changes in the system.

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