Clinical governance (CG) is the organization and performance of the activity of a healthcare facility, aimed at empowerment and participation, in strategic and management choices, of all those involved in the provision of healthcare services.
In the context of the CG, the Istituto Superiore di Sanità (ISS, the National Institute of Health in Italy) performs functions to support research activities on the organizational models in use in the healthcare system and, in particular, the process of continuous improvement of the quality of services.
The sectors of the CG identified as priorities for the ISS are: guidelines; information and involvement of citizens and patients; Essential Levels of Assistance (LEA); patient classification system; clinical risk management; evidence-based medicine, health impact assessment and Health Technology Assessment (HTA).
HTA is a multidisciplinary process that uses explicit methods to determine the value of a health technology in different phases of its life cycle. The aim is to support decision making in order to promote a fair, efficient and high-quality health system.
Health technologies being evaluated include drugs, devices, tests, medical and surgical procedures used in health care, professional practices, measures for the prevention and rehabilitation from diseases, and organizational and support systems in which health care is provided.
To determine the value of a health technology in different phases of its life cycle, different strategies are implemented: creating evidence on new technologies and on those already in use to help assess their real value; evaluation of evidence to produce HTA documents; promoting the use of HTA documents in planning and programming activities of the National Health Service (NHS) at national, regional and local level.
The ISS has initiated synergies with 53 national and regional institutions and bodies called Collaborating Centers for Clinical Governance.