title: IV steroids for MS relapse: clinical governance implications.
abstract: The face of the NHS is set to change enormously during the next decade providing more choice, more personalized care and real empowerment of people to improve their health (Department of Health, 2005b). Fundamental to this approach will be the management of patients' health needs in the community setting. Using a robust clinical governance framework, the MS team at the National Hospital for Neurology and Neurosurgery worked with the voluntary and commercial sector to design a trial to gather evidence for a new approach to the management of acute MS relapse using intravenous steroids within a home environment. The study was completed in advance of recent governmental initiatives/reforms. This paper focuses on the clinical governance implications of cross-boundary working. It is hoped that by sharing the processes put in place, others contemplating the delivery of acute care outside of hospitals or design of collaborative research trials will find the frameworks useful.
authors.affiliation: National Hospital for Neurology and Neurosurgery, University College London Hospitals, NHS Foundation Trust.
authors.forename: Emily
authors.initials: E
authors.lastname: Harrison
authors.forename: Bernadette
authors.initials: B
authors.lastname: Porter
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D003152:Community Health Nursing / Q000193:education / Q000458:organization & administration*; D003659:Decision Making, Organizational; D004509:Education, Nursing, Continuing; D018166:Health Care Reform / Q000458:organization & administration; D006301:Health Services Needs and Demand; D018718:Home Infusion Therapy / Q000451:nursing*; D006801:Humans; D007258:Informed Consent; D007262:Infusions, Intravenous; D008131:London; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000451:nursing / Q000523:psychology; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D010353:Patient Education as Topic; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration; D012008:Recurrence; D017751:Safety Management / Q000458:organization & administration; D013222:State Medicine / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration
chemical_list: D000893:Anti-Inflammatory Agents