The recent release of a new clinical governance framework in Victoria has made the board’s role and how to achieve good clinical governance much clearer. So what is expected of boards and what are some things you should do right now to make sure your health, aged care or disability service meets these expectations?
Make sure your board understands Clinical Governance
The new clinical governance framework makes it clear that all boards must be highly skilled, independent and effective. To achieve this, Safer Victoria sets out a clear number of responsibilities including “ensuring it has the necessary skill set, composition, knowledge and training to actively lead and pursue quality and excellence in healthcare” and “ensuring robust clinical governance structures and systems across the health service...”. In order to achieve this, it is important boards schedule and receive regular clinical governance training.
Read, understand and share the new framework
In June 2017, Safer Victoria released “Delivering high-quality healthcare, Victorian clinical governance framework” designed “to inform and guide good clinical governance”. The framework was developed to help health services deliver the recommendations set out in the recently released “Targeting zero: the review of hospital safety and quality assurance in Victoria” (Duckett) report. The Duckett report was in turn written as a result of a review of the Department of Health and Human Services’ (DHHS) response to a cluster of perinatal deaths that had occurred at Djerriwarrh Health Services. The new framework is clear, accessible and compulsory reading for Victorian care providers.
Look at your service in terms of the 5 domains described in the framework
The framework groups the systems required to develop and maintain a high-performing organisation into five domains:
Leadership and culture: High quality health care requires engaged clinicians and patients. This culture needs to be developed on purpose from the board down and not left to chance.
Consumer partnerships: The “consumer” is not just the patient, resident or client, but their families, care givers and the community within which the care is delivered.
Workforce: Staff need to be safe, engaged, empowered and involved in planning and resource allocation.
Risk management: Health care has inherent risks and clinical risk needs to be integrated into the broader risk framework reviewed by the board.
- Clinicians need to be supported to develop a shared understanding of the care pathway and goals with consumers.
- Clinicians are expected to review their practice and their peers, embrace teamwork, and contribute to improving care.
The framework provides questions you should ask as well as indications of success by which you can judge your service.
Think about consumer partnerships
While the consumer has long been the centre of the health care organisation, the framework now requires they are more actively involved. This means providing consumers with (among other things):
- The relevant skills and knowledge to participate fully in their care to the extent they wish
- The opportunity, information and training to fully participate in organisational processes for planning, monitoring and improving services.
This is a much higher level of engagement than previous and will require most health services to develop or change their ways of having consumers involved in their service. Look at your Consumer Engagement Committees or Representatives; are they trained and involved? Does the communication work both ways – both getting feedback from consumers but also providing information back to patients, residents and communities?
Understand Practitioner Information Exchange
When any health care service credentials a health practitioner, they need to check their registration with the Australian Health Practitioners’ Regulation Authority (AHPRA). In order to make sure organisations are kept up to date with changes to registrations, AHPRA has introduced the Practitioner Information Exchange (PIE). This service enables health care providers to register a list of health care practitioners who work with their service and to be notified immediately there has been a change to the registration status of a practitioner. Make sure your organisation has used the AHPRA register to check the status of all practitioners and registered for the PIE service.
Vivienne Corcoran FAICD, is an experienced consultant and board member in the health sector. She is Chair of Statewide Autistic Services, a senior consultant to Pitcher Partners and regularly conducts Clinical Governance workshops for the AICD.