Amana Living Clinical Governance Framework
Establishing a Clinical Governance Framework
Clinical excellence is at the centre of all health care services which are delivered throughout Amana Living. To that end Amana Living has established a Clinical Governance Framework which defines the principles, structure and processes that underpin service quality, continuous improvement and client and resident safety.
Drawing from Foundation Documents & Standards
Clinical Governance has been defined as a framework through which health services 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 (Scally and Donaldson,1998)
The purpose of a clinical governance framework is also to provide an organisation with guidance about how to sustainably achieve excellence in health care. Additionally a framework is an overarching tool which facilitates the process of monitoring the performance of the organisation against the standards that the organisation has set for itself and committed to achieve.
The Amana Living Clinical Governance framework has been developed by identifying those key health care principles, regulations and standards that are set out in a variety of documents including; the Aged Care, Home Care and Transition Care accreditation standards, relevant pieces of legislation and the WA Department of Health Clinical Governance framework. These documents underpin the delivery of Aged care services and programs in Western Australia and contain the essential elements which are the building blocks and the foundations from which the Amana Living Clinical Governance Framework is based on, as outlined below.
The Amana Living Clinical Governance framework, as shown in the diagram below, comprises four pillars containing multiple integrated processes which create an environment of transparent responsibility and accountability.
The framework has a number of simple essentials;
To initially achieve clinical and care excellence, two fundamental Pillars must be operating effectively:
1. Workforce Responsiveness:
The recruitment and development of health professionals with relevant qualifications and appropriate training to operate at a consistently-high level of knowledge, skill and behavioural competence.
2. Service Quality:
Ensuring the type and range of services and programs delivered meet stakeholder needs are clinical efficacious and based on evidence-based practise.
To monitor and continuously improve clinical and care excellence, two further Pillars are required
3. Risk Management:
A comprehensive incident and hazard management system, together with robust clinical assurance and compliance programs which either identify or manage risk or both.
4. Clinical and Care Effectiveness:
Outcome measurement and evaluation programs are in place where ever practical and these are underpinned by systems including IT to facilitate effective data and information collection and collation. Associated with this a robust and accessible model of consumer feedback is in place.
However, a clinical governance framework cannot operate within an organisation in isolation. To ensure the Amana Living Clinical Governance Framework is durable and sustainable broader organisational requirements need to be in place. Diagrammatically these are represented by two additional pillars, Leadership and support Systems.
Which ensures clear organisational direction, appropriate resourcing and good overarching governance is in place?
6. Support Systems:
Ensuring appropriate organisational systems, infrastructure and process are in place to support clinical service delivery.
Clinical Governance Committee and Sub Committees
To ensure good governance is achieved an Amana Living Clinical Governance Committee has been established. The fundamental purpose of the committee is to monitor the performance of the organisation against the standards and requirements which the organisation has recognised need to be both achieved and maintained. The committee will have an increased level of scrutiny and focus on areas of clinical risk and issues which significantly limit the organisations ability to delivery programs and services. Finally the committee will also apply a model of continuous improvement.
To support the function of the Clinical Governance Committee three subcommittees have been formed and are aligned to specific pillars of the framework. These committees will have a workgroup focus looking in greater detail and often ‘working up’ and developing documents and proposals to bring to the Clinical Governance Committee. This ensures the clinical Governance Committee is able to focus on overarching monitoring and governance. The distribution of responsibilities is as follow;
- The elements within the Service Quality Pillar will fall within the responsibility of the - Clinical Policy Committee
- The elements within the Workforce Responsiveness Pillar will fall within the responsibility of the - Workforce Responsiveness Committee.
- The elements within the Risk Management and Clinical Effectiveness and Care Pillars will fall within the responsibility of the – Clinical Risk and Performance Committee
Other forums and clinical advisory groups that support the delivery of quality health care include the Medication Advisory Committee and the monthly Clinical Forum.
Developing, Implementation and Clinical Governance Oversight
It is primarily the role of a Clinical Governance team and those responsible for quality oversight to actively monitor the performance against the four (4) pillars which make up the Clinical Governance Framework.
To help drive and foster Clinical Governance within Amana Living the role of General Manager Health Care has been developed as part of the Leadership Team. A Care and Services team reports to that role and collectively supports all parts of the organisation reach and maintain clinical and care excellence.
The following diagram illustrates the inter-relationship between the foundation documents which are used to put ‘flesh on the bones’ of the clinical governance framework, the framework itself and the Health Care team which plays a key role in assisting the operational elements of the organisation meet the standards as outlined in the framework. The team also plays an important role in monitoring how well the organisation is performing against the standards within the framework, which they have signed up to.
Amana Living Health Governance Model and the Linkage Created By The Health Care Team