CLINICAL GOVERNANCE IN AUSTRALIA

Abstract

Purpose – The purpose of this paper is to overview, background and context to clinical governance in Australia, areas for further development and potential learnings for other jurisdictions. Design/methodology/approach – Commentary; non-systematic review of clinical governance literature; review of web sites for national, state and territory health departments, quality and safety organisations, and clinical colleges in Australia.

Findings – Clinical governance in Australia shows variation across jurisdictions, reflective of a fragmented health system with responsibility for funding, policy and service provision being divided between levels of government and across service streams. The mechanisms in place to protect and engage with consumers thus varies according to where one lives. Information on quality and safety outcomes also varies; is difficult to find and often does not drill down to a service level useful for informing consumer treatment decisions. Organisational stability was identified as a key success factor in realising and maintaining the cultural shift to deliver ongoing quality.

Research limitations/implications – Comparison of quality indicators with clinical governance systems and processes at a hospital level will provide a more detailed understanding of components most influencing quality outcomes.
Practical implications – The information reported will assist health service providers to improve information and processes to engage with consumers and build further transparency and accountability. Originality/value – In this paper the authors have included an in depth profile of the background and context for the current state of clinical governance in Australia. The authors expect the detail provided will be of use to the international reader unfamiliar with the nuances of the Australian Healthcare System. Other studies (e.g. Russell and Dawda, 2013; Phillips et al., n.d.) have been based on deep professional understanding of clinical governance in appraising and reporting on initaitives and structures. This review has utilised resources available to an informed consumer seeking to understand the quality and safety of health services.

Keywords Clinical governance, Performance reporting, Quality and safety, Accreditation, Quality outcomes, Information and processes

Paper type General review

Clinical Governance: An International Journal Vol. 20 No. 2, 2015
pp. 56-73

© Emerald Group Publishing Limited 1477-7274
DOI 10.1108/CGIJ-03-2015-0008

Methodology

The review utilised a non-systematic web-based literature search and interviews with key stakeholders.

The literature search was limited to Australian data identified through key search terms. Search terms included: patient outcomes, quality and safety, patient satisfaction, patient experience, hospital performance, comparing hospitals, clinical governance, health standards and health accreditation.

The Department of Health and individual state web sites were accessed and searched for clinical governance policy and processes, quality and safety, outcome reporting, key performance indicators and patient satisfaction.

The web sites of the medical and surgical colleges were accessed and searched for clinical governance policy and quality and safety.

The focus of the approach was to identify from an “informed consumer” perspective:

• information that was available on the quality and safety of the Australian Healthcare System;

• the level at which quality and safety outcomes are measured and reported;

• challenges in accessing this information; and

• the usefulness of this information to patients.

Key stakeholder interviews were used to test and clarify findings from the literature. Interviews were undertaken with the Chief Executive Officer and Chief Operating Officer of the Australian Commission on Safety and Quality and in Health Care (ACSQHC); Deputy Chief Executive Officer of the NSW Clinical Excellence Commission (CEC) and the Australian Institute of Health Innovation.

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Rendalls _ Spigelman Clin Gov in Australia 2015 (1)