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In response to quality challenges highlighted by the Covid-19 pandemic, the Institute for Quality Improvement (IHI) has looked at how to increase the adoption of effective quality improvement (QI) practices in nursing homes in the United States. Despite the differences in regulatory requirements between countries, the findings are relevant for all involved with aged care: providers, managers, staff, policymakers and advisers.
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The Code of Conduct for Aged Care describes the behaviour expected of aged care providers, their governing persons (e.g. board members and Chief Executive Officers) and aged care workers. The Code gives the Aged Care Quality and Safety Commission (the Commission) the power to deal with behaviour that is not consistent with the Code.
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Governing bodies play a critical role in aged care – they set the direction for, and culture of, the organisation, directly influencing the safety and quality of care provided to consumers.
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The Victorian Clinical Governance Framework (VCGF) developed by Safer Care Victoria (as a result of recommendations made in ‘Targeting Zero’) has been a well-adopted state-based clinical governance framework. A recent review by the Victorian Auditor-General’s Office (VAGO) of four state health services against the Victorian Clinical Governance Framework offers a useful illustration in assessing the extent to which frameworks align - noting that whilst Victorian health services must have individual clinical governance frameworks suited to their local needs, these must also comply with the VCGF.
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"Governing bodies of approved providers should be comprised of members whose integrity, skills and independence enable them to act, first and foremost, in the best interests of the people receiving care. Evidence before us has demonstrated, in particular, a lack of adequate clinical governance expertise on the boards of some providers. We consider that each governing body should have a care governance committee, to ensure that quality of care is considered at the highest level of the organisation. The chair of the care governance committee should be a member of the governing body and have appropriate experience in providing care. The focus of care should cascade from the governing body through the executive leadership to all staff."
The Aged Care Quality Standards (Standards) set regulatory requirements for the provision of care and services in aged care. All approved providers of residential care, home care, and flexible care in the form of short-term restorative care must comply with the Standards, which are embedded in Schedule 2 of the Quality of Care Principles 2014 (made under the Aged Care Act 1997).
