Clinical governance
The key to person-centred clinical excellence
Petrina Turner-Benny, UK executive director and deputy CEO of Leecare Solutions, explains how clinical governance creates an opportunity for care staff and managers alike to constantly measure the pulse of the clinical health of their business, enabling them to plan more effectively and to intervene faster and earlier to improve resident safety
Clinical governance is a relatively new concept that originated out of the NHS late last century in response to a number of significant and avoidable clinical events. It was originally defined by Gabriel Scully and Liam Donaldson in 1998 as: “ … a system through which healthcare organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care, creating an environment in which excellence in clinical care will flourish.”1 For many decades, health agencies around the world have grappled with how to raise the quality of healthcare in an environment not at all conducive to doing so. Managers desperate to instil change have been stymied by a lack of
direction, lack of adequate care data, and limited or inappropriate resources. This has been combined with the duplication or complete absence of appropriate service provision between primary and secondary care and geographical and service patch protection which prevents adequate health data being shared between agencies. This overwhelming burden of bureaucracy has meant the health consumer is constantly at risk of not receiving the level of care they need or deserve, particularly when accessing care across different thresholds. Faced with the ongoing requirement to meet fiscal and operational targets, managers must often make compromises that are at the expense of providing person- centred care.
Prior to the widely accepted and adapted concept of clinical governance, healthcare agencies sought to plug their quality gaps through quality assurance programs that were not always mandated or underpinned by appropriate leadership nor effectively joined up or communicated adequately to care staff to effectively inform change. Hence, a myriad of different definitions and frameworks have evolved to understand and define clinical governance as it best relates to different healthcare environments. However, in the care home environment, at its essence it can be easily described as an opportunity for care staff and managers to constantly measure the pulse of the clinical health of their business; to plan effectively, to intervene quickly and early to improve resident safety, and to ensure that learnings are taken on board by individuals, the teams responsible, and embedded into the organisational culture at large. The utilisation of a clinical governance
framework in the care setting becomes immeasurably more powerful if the same level of quality and safety guardianship utilised in the individual care home is reflected across the entire health spectrum. When standardised data collection tools are used, and aged care quality indicator data is able to be seen in the context of the wider health system, integrated and informed resident data is able to cross the divide between primary care and the NHS. Incorporating relevant data input from secondary and tertiary care hospitals, allied health, other social care agencies, and other community services impacting the care of an individual will no doubt result in clinical outcome gains being seen across the entire health system. What can be learnt from the interventions we provide to one resident or
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www.thecarehomeenvironment.com March 2023
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