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Tips for a successful clinical governance framework


Aged care organisations need to ensure their approach to clinical governance puts aged care clients at the centre, a provider’s head of quality and safety tells Australian Ageing Agenda.

It is important for providers to understand the meaning of organisational performance in regards to antimicrobial stewardship, the use of restraints and open disclosure, said Sarah Marciano, executive director of quality and safety of home aged care provider integratedliving.

“The first step is to understand what each of these mean in the context of the care and services being provided by the organisation,” Ms Marciano told AAA ahead of her appearance at the Governance in Aged Care conference in Sydney this week.

Providers must then assess how to capture the data, understand it and share the findings with the whole team including the board and frontline staff, she said.

Sarah Marciano

The goal is to keep customers at the centre of care, Ms Marciano said.

“The ultimate aim is to achieve better outcomes for our customers by changing clinical and care practices to be able to quantify the results.”

Ms Marciano is speaking about creating and applying a comprehensive clinical governance framework in aged care at the conference.

Integratedliving established a clinical governance, innovation and improvement team last year within its quality and safety group.

“The team is responsible for providing sound clinical strategic direction and policy leadership in clinical practice for the organisation.

“They develop clinical and care-related policy and procedures in conjunction with our operation’s team, conduct clinical audits and provide clinical oversight and advice via a clinical help desk for frontline staff,” Ms Marciano said.

Integratedliving is also working with St Vincent’s Psychogeriatric Service, which provides clinical supervision, customer case conference and education sessions to the team.

“Having a clinical governance framework and committee is just part of the picture. This dedicated team and the collaborative work they do with the rest of the organisation is what brings the clinical governance framework to life,” Ms Marciano said.

As a result of the framework, integratedliving has achieved increased visibility of issues and opportunities and improved ability to identify the root cause of the issues.

Providers can overcome any challenges by keeping the focus on customers, Ms Marciano said.

“Keep taking it back to the outcome and benefit for the customer. Hold people accountable whilst ensuring it’s a no blame culture and make sure that people know from the outset that everyone has a part to play in this, it really is everyone’s business.”

Tips for developing a framework

While the initial commencement phase may seem daunting, it will begin to make sense once started, Ms Marciano said.

“Draft the written framework document to give scope and context, but then put it aside and see what is really happening out there and what needs to stay, change and begin. Then revisit the written document and add the real detail.”

Ms Marciano encourages providers who have already established a clinical governance framework to take another look at it.

“For those who think they already have it sorted, step back and challenge yourself and the team to consider if your clinical governance framework is just a document that ticks a box, or really part of everyday practice and daily operations,” she said.

“Keep it simple, practical, relevant and achievable and always with the outcome and benefit for the customer at the forefront,” Ms Marciano said.

The Governance in Aged Care conference will take place at the Sydney Boulevard Hotel 29-30 May.

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One Response to Tips for a successful clinical governance framework

  1. trudy Sutton May 30, 2019 at 2:56 pm #

    hi i was wondering if you have a clinical skills matrix that guides the composition of the committee

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