Strengthening healthcare quality through identification of risk,improving quality standards and an outlier considering the integration between environmental status and human health

摘要

The seven articles in this issue of IJHG provide interesting food for reflection about aspects of health governance in today's rapidly changing global environment. Six of these articles encourage consideration of issues relating to managing risk and improving quality. Avery et al. (2021) remind us that to be effective monitors and planners in healthcare facilities, it is essential that board members have the management skills required to move healthcare through the 21st century with all the existing and potential future problems of this period in time. Azilaku et al. (2021) describe the first steps of entering into a clinical governance mindset in Ghanian hospitals. This indicates progress with the potential to reduce risk and improve quality but requires doctors, managers and other health workers to sign up to a clear commitment to create an ethical, equitable and modern health service. Rajabi et al. (2021) report on the problems of integrating state healthcare provision with healthcare provided by NGOs in Iran. Successful integration could go a long way to reduce risk and improve the quality of care in both sectors. The authors have outlined some solutions. Powel (2021) takes a historical perspective, illuminating problems in a new health service lauded by the UK government as "the best in the world". Clearly for psychiatric and mental disability patients in the 1960s, it was not the best, and this paper details failures in the system while highlighting elements leading to change. Glett and Wigg (2021) introduce the concept of the ETTO principle. The ETTO describes what healthcare professionals do on a daily basis to attempt to minimize risk and increase care quality while grappling with issues such as staff shortages and increasing healthcare demands. Van der Elst et al. (2021) focus on a problem which affects us all, as we all face both our own eventual frailty and perhaps more imminently, the provision of care for older relatives. They propose developing a tool using the four domains of frailty and the demographic risk factors to identify which of the elderly population are most likely to suffer from frailty and thus be most likely to require community care. The outlier, as previously mentioned, is the article by Simmonds and Valgarda (2021) on the proposed meat tax in the UK. Combining a concern for human health and animal welfare with political expediency and environmental protection, this article is not easily slotted into a theme of reducing risk and improving quality. However, to ignore the issues is to close our eyes to problems that will increasingly affect global health. Therefore, I welcome this submission as something to stimulate our brains and remind us that health is a much wider issue than providing prevention or cures in hospital or community settings.