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Clinical Governance “The system by which the governing body, managers, clinicians and staff share responsibility and accountability for the quality of care, continuously improving, minimising risks, and fostering an environment of excellence in care for consumers/patients/residents” Australian Council on Healthcare Standards 2004 Expectation that all health services will have a formal and effective clinical governance framework in operation.
Victorian Clinical Governance Framework • Consumer participation • Clinical effectiveness • Effective workforce • Risk management
Examples • Melbourne Health • Alfred Health
Features of Framework • Systematic and integrated • MH Board and Executive sponsorship • System wide accountability and responsibility including the organisation and practicing clinician • Reflects regulation, standards and evidence • Involves clinical audit and evaluation • Includes consumer and stakeholder engagement • Collaboration across professions and services • Recognise clinicians operate within an imperfect and sometimes inadequate environment
Goals of Framework • Safeguarding standards of care • Reproducibility of clinical standards and outcomes across similar settings • Providing safe services, with an emphasis on preventing and managing clinical risks • Create and sustain an environment where clinical excellence can flourish • Continue to promote the clinical expertise of physiotherapists and support the advancement of physiotherapy scope of practice where appropriate • Be internally managed, externally transparent
Some specific features • Position descriptions • Recruitment processes • Upskilling and credentialling • e-credentialling • Clinical practice guidelines • Work based assessment • Peer review processes • Continuing professional development • Supervision and mentoring • Annual discussion • Scope of practice/clinical/documentation audits • Reporting and management of adverse outcomes, complaints, compliments. • Satisfaction surveys
