Clinical governance
through various channels. Hence, out of your quality assurance
meetings should come the in-depth analysis of clinical indicator data including interventions that were successful or otherwise – the results of which can then be relayed to appropriate staff. Just informing the champions of what needs to be changed, and not communicating to and involving all staff involved in the relevant aspect of that resident’s care, will inevitably lead to a breakdown in process and no change in the resident’s clinical outcomes. In order to ensure the effective management of all clinical risks, the entire care team needs to be rallied when and as necessary.
Electronic benefits Clinical governance lends itself easily to an electronic program which enables staff to have high visibility of the health of a range of different quality indicators at the push of a button. Most electronic programs provide at least one real time dashboard, which prevents managers from having to delve into a myriad of folders and pore over excel spreadsheets to derive data. With the advent of artificial intelligence, there is now even less excuse for governors of care to fail to identify and closely manage clinical risk. An electronic program can easily cut and slice which indicator information can be seen by which health/care discipline so the data is always relevant to the workers scope. For instance, kitchen staff need to see a real time change to someone’s texture modified diet but will likely not be remotely interested in the continence related risk to a resident.
Being able to see real time data on a dashboard or via a report means managers can circumvent worrying trends and intervene before a resident experiences an adverse clinical event and becomes very unwell. An electronic program will provide protection for junior staff when issues need to be escalated. An alerts dashboard will ensure transparency, as the accountability to act is shifted to more senior members of staff. Furthermore, a Key Performance Indicator dashboard will enable managers to see a full month-to-month data set for comparisons. An electronic clinical governance
program that regularly pre-empts or prevents major adverse events from
teams to improve clinical performance and effectiveness. Through this process, a feedback loop is then able to determine and inform training requirements for staff. Mandatory clinical training is most effective when provided within the context of the quality indicators being measured. Understanding the knowledge and process gaps identified through clinical governance will mean training can be effectively tailored to meet any knowledge and process deficits. A cultural shift to drive staff engagement and commitment at both an individual and care home wide level is much more likely to occur when staff understand the ultimate goal they are aspiring to achieve and where there is transparency and a safe environment to feedback where staff are falling down in their attainment.
If nothing else, a clinical governance
occurring will no doubt result in significant productivity and cost savings. In a sector that will always be challenged by lack of funding and a lack of skilled resource, clinical governance by its very nature has the ability to enhance operational efficiency and effectiveness, which is a vital component of probity.
For care staff, this might be reflected in more opportunities to work to the top of their scope where staff can be supported to be more self-aware of the quality of their interactions and more innovative in their care solutions. For quality assurance managers, the ability to review quality indicator reports in real time and escalate concerns or provide immediate responses to staff is incredibly reassuring. For operational managers, such a programme might be seen in their ability to be more collaborative and instructive, guiding their staff through professional development opportunities to reduce duplication and waste, reduce emotional distress for staff, raise the quality bar, and ensure high levels of quality care at all levels of the organisation. Clinical governance is the conductor of an orchestra that collects relevant data, contextualises it, analyses it and then derives interventional plans to assign accountabilities to specific individuals and
A sound clinical governance programme should be intuitive, flexible, and responsive in real time
March 2023
www.thecarehomeenvironment.com
programme will assist with identifying what the actual problem is you need to solve, whether the accountability for change sits at an individual, team, or care home level, and, most importantly, whether the CEO has effectively communicated the vision and provided the right leadership to create a culture where clinical safety is a priority for every member of staff.
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Reference 1 Scully, Gabriel, and Liam J Donaldson. Clinical Governance and the Drive for Quality Improvement in the New NHS in England. BMJ 317 (1998): 61
Petrina Turner-Benny
Petrina Turner-Benny is the UK executive director and deputy CEO of Leecare Solutions. Petrina is a registered general and mental health nurse and she is passionate about outstanding person-centred nursing assessment and care.
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