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Variations in the way care is accessed or delivered, and in clinical outcomes, can be highly informative. It may be that such variations are warranted or expected (for example, the surge in telehealth at the outset of the pandemic, or in the number of infection-related deaths) or may reflect person-centredness and individual choice. However sometimes variations may be ‘unwarranted’ and unveil weaknesses in the quality of care, or worse still, herald the risk of harm.

Regulation can support clinical governance.  This is particularly palpable in aged care reform, where new legislation and revised standards shine a spotlight on clinical governance in way that has not been done in the Australian aged care system before.

Many of the provisions introduced by the Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022 will enhance clinical governance in aged care – this is how.

Clinical governance might be considered as being about “how we control, regulate direct or oversee the assessment and management of a person’s health to support optimal outcomes”, where outcomes encompass the person’s “experience of care”.  In the context of palliation, while we cannot alter the outcome, we can certainly aim to enhance a person’s end-of-life experience.

Robust clinical trials drive learning, innovation and hence continuous improvement in evidence-based care.  Not only do clinical trials promote good clinical governance in this way, but good clinical governance must underpin clinical trials. 

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.

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

"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).

Person-centred care in clinical governance requires partnership with consumers – this ‘recognises the value of the consumer's voice, and the need for consumer experience and expertise to help shape decisions about health care at the level of the system, service, and individual.’