Resources

Trying to improve care in human services can be overwhelming. We start out with great aspirations to fix a care quality issue. But as we get closer to the problem it appears to loom ever larger, and we wonder what we’ve got ourselves into. Most care quality issues are entrenched and multifaceted and can’t be solved by a single solution or big-bang change. Often our initial enthusiasm wanes and we default to revising the procedure and running training because everything else seems too hard. Essentially, we’ve wasted time and effort on maintaining the problem, rather than finding the solution.

Striking a balance between patient safety and professional autonomy is a complex issue that requires a multifaceted approach. Multiple challenges stand in the way of a balanced approach, such as...

The central role played by governance and leadership in the actions (and inactions) relating to quality of care and patient safety has been repeatedly identified by inquiries and investigations into major organisational failures. They show that governance and leadership - through their influence on priorities, oversight, management and culture – are often part of both problem and solution.

Effective clinical leadership has long been an aspiration for acute care services. With the establishment of clinical governance in aged, disability and community care, these sectors are increasingly focused on how to develop leaders for quality clinical care. This AICG Paper explores the concept of clinical leadership for quality care as an ‘everyday’ responsibility across human service organisations.

James Reason once characterised the goal of error investigations as ‘draining the swamp, not swatting mosquitoes’. Critical incidents arise from the interplay between active failures (eg. not double-checking for allergies before administering a medication) and latent conditions (eg. workload).

QI implementation is complex as it often spans over multiple organisational levels requiring active participation of employees and managers, and involves improvements and modifications of underlying care processes.