0716 - applying clinical governance - AHF

Question 1

What is clinical governance?

Answer 1

A systematic and integrated approach to quality assurance and review of clinical responsibility and accountability that improves quality and safety resulting in optimal patient outcomes (in the most efficient, affordable and sustainable manner as possible).

Question 2

What are the 4 pillars of clinical governance?

Answer 2

1. consumer participation: focus on consumer-centred care
2. clinical effectiveness: taking responsibility for and caring for patients (e.g. shift changeover)
3. effective workforce: skills, knowledge to fulfil roles
4. risk management: clinical, organisational, workplace safety

Question 3

Outline the 2 themes in clinical governance.

Answer 3

1. individual clinical engagement: clinicians understanding their roles as decision-makers in terms of care and resources needed
2. system governance: employees are part of the system, so if there are problems, you are part of the problem and the solution

Question 4

Where should we head with clinical standards?

Answer 4

• we should understand how people think and make it easy to do the right thing and hard to do the wrong thing
• consider fast (habit, culture) and slow thinking (considered judgment)
• access to information (e.g. supply iPads, apps, wifi, etc.)

Question 5

How can we engage clinicians?

Answer 5

Need clear structure of input and accountability, not just hope it will work (engaged doctors drive performance).

Question 6

How can we improve clinical governance?

Answer 6

• change the language (it’s all about the patient, not the doctors or the government)
• engagement is a management task and a social process (get to know each other)
• involve consumers
• value people’s time
• move to the clinicians (their problems are your problems)
• take a whole of system approach (interdependence is essential)
• support behaviour change
• support clinical leaders

Question 7

What are the 4 types of governance structures?

Answer 7

1. hierarchical
2. market
3. network (share, distributed)
   - only one that will really work in a public hospital
   - no one actor or agency has all the knowledge and power
4. mixed

Question 8

Why is governance important?

Answer 8

It forms the framework for all aspects of an organisation’s activities.

Question 9

How would you go about getting involved in ensuring the systems in place in hospitals provide the best patient care and outcomes?

Answer 9

• have confidence to speak up
• know who supervisor is
• speak to person you relate to better; i.e. mentors