Resources

Professional boundaries in healthcare delineate the therapeutic relationship. They have been defined as ‘parameters that describe the limits of a relationship in which one person entrusts their welfare to another and to whom a fee is paid for the provision of a service’ - or, more broadly, as the ‘edge of appropriate clinical care’.

The Royal Commission into Aged Care Quality and Safety noted in its Final Report, presented on 26 February 2021, that aged care ‘should be able to deliver compassionate and kind care built on respectful relationships’. Person-centred care (or ‘consumer-centred’ care) was already central to the way aged care was expected to be delivered, under the Aged Care Quality Standards which have been in effect since 1 July 2019.

The term ‘clinical governance’ was first coined in the context of the National Health Service (NHS) in the United Kingdom, being ‘a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.'

In thinking about clinical governance, we must also consider the range of factors that impact the safety and quality of care - whether intrinsic or extrinsic to the person. This will inform our approach to clinical governance in any given situation. Intrinsic factors might relate to the person themselves, such as a disability; extrinsic factors might relate to some external condition, such as homelessness and other aspects of a person’s social circumstances.

Compassion is an extension of empathy. It can be defined as ‘the feeling or emotion, when a person is moved by the suffering or distress of another, and by the desire to relieve it’. The desire to help distinguishes compassion from empathy - which, in contrast, may be defined as ‘the ability to imagine and understand the thoughts, perspective and emotions of another person.’

As the COVID-19 pandemic continues to cast a shadow over the health of the world, we continue to learn about clinical governance at scale. We have previously drawn analogies to Australian government responses with clinical governance principles - however the parallels don’t stop there.  Across the world, the economic impact of the pandemic has been palpable and is illustrative of the co-dependent relationship between health and money, where better health outcomes are known to correlate with better economic outcomes.

Last week (on 15 November 2021) new NDIS Practice Standards (Standards) came into force in relation to severe dysphagia. Under the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 (Cth), the Standards specify minimum requirements regarding the quality of supports and services to be provided by registered NDIS providers (Providers).

In this webinar recording, A/Prof Debora Picone, CEO at Australian Commission on Safety and Quality in Healthcare, paints a holistic picture of clinical governance across all sectors and explains why Standard 1 is so important. She discusses the cross-sector health and care workforce in the context of clinical governance, highlights the learnings of the review of Standard 1 and provides her key takeaways for health and care workers to pursue safe and quality care.

The concept of person-centred care in clinical governance includes supporting people in making choices on the basis of their values and preferences within a particular context, founded on their understanding of risk and appetite for it.

Primary and community care are fundamental to population health. They support the community’s physical and mental well-being through their role in health promotion, health literacy and preventative care, as well as in the early intervention and ongoing management of acute and chronic conditions, including end-of-life care