Physiotherapy April 2002/vol 88/no 4

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Book reviews

Radcliffe Medical Press, Abingdon2000 (ISBN 1 85775 413 1). Illus. 266 pages

by Ruth Chambers and Gill Wakley £19.95Clinical governance is often talked about and frequentlymisunderstood. Using simple language, clinical governanceis presented here in a sensible, non-threatening andunderstandable form.

The first section gives a clear, relevant definition of clinical governance, linking it to professional and servicedevelopment and how to establish priorities by undertakinga baseline review. The second part is divided into 14modules, each covering a pillar of clinical governance. The final section addresses the challenges of qualityimprovement. The appendix contains helpful informationon electronic and written resources.

Cartoons are found throughout the text, which wrylyreflect practice life. Textboxes give examples and dilemmasfor discussion, which I found very helpful in the con-fidentiality section. I found figure M10.1 ‘Making difficultdecisions about treatment, funding or resources’particularly useful. Many of the 183 references cited seemedintriguing enough to invite follow-up.

This book has been written for doctors, nurses, healthvisitors, therapists and practice managers, as individuals andteams. Reading the book gives insight, but to work through it individually or with a team would be particularly

beneficial. It is chiefly of interest to community therapists,but the sections identifying service and learning needs,confidentiality, coherent team working and meaningfulpatient and public involvement will be relevant to allphysiotherapists.

Each module ends with space to record action planning,outcome evaluation and the learning achieved, consideredfrom the viewpoint of the individual, team and organisation.The book is available in shortened form on line; anelectronic format may be more suitable for some andrecording would be direct.

Most modules could be expanded to become a book;therefore suggestions may appear elementary and should be followed with care. For example: ‘You may encourageresignation or early retirement when the rectifying ordisciplinary actions taken have had insufficient effect and noalternative can be found.’ It would be important to do thiswithin the context of employment law and not contribute toconstructive dismissal. The problem is well addressed bygiving further reading lists. Inevitably, more detail wouldrender the book less reader friendly.

Modules contain ideas for individuals’ actions to establishan aspect of clinical governance. The entire team isincluded; doctors are seen as taking the lead and thetherapists’ contribution is relatively low key.

I enjoyed reading this book immensely and will use it toconsider issues with a variety of staff groups. I feel that usingit would be wonderful preparation for a clinical governancereview.

Catherine Simpson BA MCSP

Making Clinical GovernanceWork for You

Springer-Verlag, Berlin2000, 2nd edn (ISBN 3 540 66395 9). Illus. 402 pages

by Susan S Adler, Dominick Beckers and Math Buck £37At 402 pages, the second edition of this work is a substantialrevision of the first edition published in 1993 with 257 pages.However, the stated intent of the authors has not changed –to provide a comprehensive coverage of practical techniquesin text and illustrations – the result being a highly accessiblebook for both newcomers to and proficient practitioners ofproprioceptive neuromuscular facilitation techniques.

This is a well developed publication. A short introductioncontextualises the authors’ philosophy and approach to PNFthat is clearly based within a ‘lineage’ of these techniquesoriginating from Kabat and Knott in the 1940s. Four

chapters that provide a clear guide to the fundamentalprocedures and techniques of PNF -- treatment planning,design, goals and evaluation, and patterns of facilitation --follow this.

These initial chapters create a sound foundation for theremainder of the publication to illustrate specific techniquesby anatomical region, and greatly expanded (from the firstedition) sections on mat activities and gait. The bookconcludes with two short chapters dedicated to ‘vitalfunctions’ -- facial muscles, speech disorders and breathing(facilitation of thoracic excursion); and activities of dailyliving. In comparison with the rest of the book this finalchapter is a little disappointing, because some excellentphotographs are, I feel, in need of support from moredetailed text.

Indeed, a feature of this revised second edition is the

PNF in PracticeAn illustrated guide

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