What is Clinical Governance?
Clinical governance is a framework that ensures health service organisations provide high-quality, safe, and effective care. It's a system that cultivates a high level of accountability across all departments in an organisation, including governing bodies, executives, staff, patients and consumers. This system aims to improve care, identify risk, maintain patient safety and comply with national healthcare standards and regulation (NSQHS, National Model Clinical Governance Framework 2017).
What is Integrating Clinical Governance?
Integrating clinical governance involves implementing a systematic approach within healthcare organisations to maintain and improve the quality of patient care. It aligns with standards set by the National Safety and Quality Health Service (NSQHS) - Actions 2.01, 3.01, 3.02, 4.01, 5.01, 7.01, Aged Care Standards - Requirement 8.3(e), and Strengthened Aged Care Standards - Actions 5.1.1, 5.1.2. This integration ensures that organisations continually evaluate, monitor, and improve their health services.
The Importance of Integrating Clinical Governance
Clinical governance is extremely important because it strengthens healthcare systems by safeguarding patient safety. This approach not only leads to better patient outcomes but also boosts staff morale and helps maintain high standard of care across the organisation.
Integrating clinical governance into healthcare organisations is crucial for several key reasons:
- Patient safety: Central to clinical governance is the improvement of patient safety and care quality. This approach reduces medical errors and ensures that the care provided is safe, effective, and patient-centred.
- Compliance with regulatory standards: It promotes continuous improvement, compliance with regulatory standards, and efficient resource use, while embracing transparency and trust in healthcare services.
- Continuous improvement: In healthcare, it helps to identify and address issues, reduce errors, improve patient outcomes, and adapt to evolving best practices.
- Reputation: Effective governance builds trust in healthcare services, enhancing the organisation's reputation and attracting skilled professionals.
- Efficient resource management: Proper management of resources not only improves operational efficiency but also ensures that healthcare services are delivered sustainably and equitably.
- Empowerment of healthcare professionals: Involving staff in governance processes elevates engagement, responsibility, and job satisfaction, positively impacting patient care.
- Legal and ethical responsibility: Integrating clinical governance fulfils ethical obligations, reflecting a commitment to 'do no harm' in healthcare.
- Data-driven decision making: This approach uses data to inform decisions, ensuring they are based on evidence and best practices.
What is the "Integrating Clinical Governance" Training Requirement?
Training in clinical governance is vital for all healthcare staff. It involves understanding the frameworks, policies, and practices that underpin the delivery of high-quality healthcare. Training must cover the relevant NSQHS and Aged Care Standards to ensure compliance and effective implementation of clinical governance practices.
Relevant Standards
Action 2.01: Integrating clinical governance - Partnering with Consumers Standard
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
- Implementing policies and procedures for partnering with consumers
- Managing risks associated with partnering with consumers
- Identifying training requirements for partnering with consumers
Action 3.01: Integrating clinical governance - Preventing and Controlling Infections Standard
The workforce uses the safety and quality systems from the Clinical Governance Standard when:
- Implementing policies and procedures for infection prevention and control
- Identifying and managing risks associated with infections
- Implementing policies and procedures for antimicrobial stewardship
- Identifying and managing antimicrobial stewardship risks
Action 3.02: Integrating clinical governance - Preventing and Controlling Infections Standard
The health service organisation:
- Establishes multidisciplinary teams to identify and manage risks associated with infections using the hierarchy of controls in conjunction with infection prevention and control systems
- Identifies requirements for, and provides the workforce with, access to training to prevent and control infections
- Has processes to ensure that the workforce has the capacity, skills and access to equipment to implement systems to prevent and control infections
- Establishes multidisciplinary teams, or processes, to promote effective antimicrobial stewardship
- Identifies requirements for, and provides access to, training to support the workforce to conduct antimicrobial stewardship activities
- Has processes to ensure that the workforce has the capacity and skills to implement antimicrobial stewardship
- Plans for public health and pandemic risks
Action 4.01: Integrating clinical governance - Medication Safety Standard
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
- Implementing policies and procedures for medication management
- Managing risks associated with medication management
- Identifying training requirements for medication management
Action 5.01: Integrating clinical governance - Comprehensive Care Standard
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
- Implementing policies and procedures for comprehensive care
- Managing risks associated with comprehensive care
- Identifying training requirements to deliver comprehensive care
Action 7.01: Integrating clinical governance - Blood Management Standard
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
- Implementing policies and procedures for blood management
- Managing risks associated with blood management
- Identifying training requirements for blood management
National Safety and Quality Health Service (NSQHS) Standards
Requirement 8.3 (e): Assesment and planning
Where clinical care is provided – a clinical governance framework is needed.
Action 5.1.1: Governing body's requirements
The governing body:
- Sets priorities and strategic directions for safe and quality clinical care and ensures that these are communicated effectively to workers and older people
- Endorses the clinical governance framework
- Monitors the safety and quality of clinical systems and performance
Action 5.1.2: Clinical governance frameworks
The provider implements the clinical governance framework as part of corporate governance, to drive safety and quality using:
- Feedback and information on experiences of older people, family, carers and workers
- Analysis of clinical safety and quality indicator data, including the mandatory Quality Indicator Program
- Contemporary, evidence based practice.
Strengthened Quality Standards framework analysis - Aged Care Quality Standards
Staff Skills Required for Integrating Clinical Governance
Before diving into the specific skills, it's important to understand that successful integration of clinical governance requires a specific skill set. These skills range from analytical abilities to communication effectively and demonstrate leadership. The following list highlights the key competencies needed:
| Skill | Description |
|---|---|
| Risk management | Ability to identify, assess, and mitigate potential risks in healthcare settings, ensuring patient safety and a secure environment. |
| Quality improvement | Proficiency in using quality improvement methodologies, conducting audits, analysing data, and implementing changes to improve the quality of care a person receives. |
| Regulatory compliance | Knowledge of healthcare regulations and standards, and the ability to apply these in practice to ensure organisational compliance. |
| Leadership | Skills in inspiring and leading teams to manage change, and promote a culture of safety and continuous improvement in healthcare settings. |
| Data analysis | Competence in collecting, analysing, and using healthcare data to inform decisions and drive improvements in patient care. |
How to Assess Staff Competency in Integrating Clinical Governance
Assessing staff competency is a critical step in ensuring effective clinical governance. This assessment should be comprehensive, covering various aspects of clinical governance skills. The following table provides a structured approach for this assessment.
- Direct observation: Supervisors or peers observe interactions with patients, focusing on the application of key skills.
- Feedback: Collecting feedback through surveys or interviews to gauge patient satisfaction and staff effectiveness.
- Self-assessment: Encouraging staff to reflect on their skills and identify areas for improvement.
- Clinical scenario: Simulating scenarios where staff can demonstrate their ability to partner with patients.
- Competency assessment: Assessing understanding of best practices and policies related to patient care.
Strategies to Support Healthcare Staff Develop Skills in Integrating Clinical Governance
Enhancing skills in clinical governance requires a strategic approach. Employees should be supported through various methods to develop their competencies effectively. The strategies listed below provide a structured framework for skill development:
| Strategy | Description |
|---|---|
| Continuing education | Regular workshops and seminars to update skills in line with evolving standards and practices. |
| Mentoring | Mentorship programs are beneficial because they provide guidance, support, and knowledge sharing between experienced professionals and less-experienced individuals. These programs foster personal and professional growth, improve job satisfaction, and enhance skill development. |
| Feedback | Regular reviews and constructive feedback on performance related to clinical governance tasks. |
| Simulation | Through simulation, staff can test protocols, refine procedures, and identify potential risks in real-world situations. It enhances team collaboration, improves problem-solving, and reinforces adherence to quality standards and safety practices, all of which are essential components of clinical governance. |
| Online learning | It enables continuous education, accommodates varying schedules, and allows for personalised learning, all while reducing costs associated with traditional in-person training. |
Sample Training Plan for the Integrating Clinical Governance Requirement
A well-structured training plan is instrumental in developing the necessary skills for effective clinical governance. The following table outlines a sample training plan that can be adapted to suit specific organisational needs.
Using the above needs assessment survey as an example - The skill requiring the most attention for integrating clinical governance are risk management and leadership. We can target learning initiatives to fill these gaps to enhance staff competency.
| Quarter | Topics | Resources |
|---|---|---|
| Q1 | Risk management | |
| Q1 | Leadership |
|
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Staff Competency Assessment for Integrating Clinical Governance - Example
To evaluate an individual's skills in operating integrating clinical governance, consider using these survey questions:
Staff Survey - Integrating Clinical Governance Competency
-
How confident are you in identifying and managing risks in a healthcare setting?
- [Answer here]
-
Can you describe a situation where you successfully applied quality improvement techniques?
- [Answer here]
-
How familiar are you with the NSQHS and Aged Care Standards relevant to clinical governance?
- [Answer here]
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Describe an instance where you led a team to implement a clinical governance initiative.
- [Answer here]
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How proficient are you in analysing healthcare data to inform decision-making?
- [Answer here]
Conclusion
Clinical governance is everyone's responsibility. Adopting strategies such as mentorship programs, simulations, and online learning highlights your organisation's commitment to patients' and staff's health and well-being. These methods foster continuous improvement, enhance professional development, and ensure healthcare teams consistently deliver high-quality care. By embracing these tools, organisations can create a more effective, accountable, and patient-centred approach to care, ultimately leading to better health outcomes in our community.
References
- Aged Care Quality and Safety Commission 2023, Aged Care Quality Standards, Australian Government, 'Requirement 8.3(e)'.
- Aged Care Quality and Safety Commission 2023, 'Stronger Standards, Better Aged Care Program - Action 5.1.1-5.1.2', Australian Government, https://www.agedcarequality.gov.au/about-us/stronger-standards-better-aged-care-program.
- Australian Commission on Safety and Quality in Health Care 2023, 'NSQHS Action 2.01', Australian Government, https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard/clinical-governance-and-quality-improvement-systems-support-partnering-consumers/action-201.
- Australian Commission on Safety and Quality in Health Care 2023, 'NSQHS Action 3.01', Australian Government, https://www.safetyandquality.gov.au/standards/nsqhs-standards/preventing-and-controlling-infections-standard/clinical-governance-and-quality-improvement-systems-are-place-prevent-and-control-infections-and-support-antimicrobial-stewardship-and-sustainable-use/action-301.
- Australian Commission on Safety and Quality in Health Care 2023, 'NSQHS Action 4.01', Australian Government, https://www.safetyandquality.gov.au/action-401.
- Australian Commission on Safety and Quality in Health Care 2023, 'NSQHS Action 5.01', Australian Government, https://www.safetyandquality.gov.au/standards/nsqhs-standards/comprehensive-care-standard/clinical-governance-and-quality-improvement-support-comprehensive-care/action-501.
- Australian Commission on Safety and Quality in Health Care 2023, 'NSQHS Action 7.01', Australian Government, https://www.safetyandquality.gov.au/standards/nsqhs-standards/blood-management-standard/clinical-governance-and-quality-improvement-support-blood-management/action-701.
