Why do we use it?
Governance refers to the operational systems and processes that control and monitor, or in other words ‘govern’, an organisation. This is not a new area to the aged care industry, however the Aged Care Quality Standards now contains a specific Standard related to this area - Standard 8 Organisational Governance. The Standard overviews how the governing body, or the Board, are responsible for the organisation overall, and need to ensure that safe and quality care and services are provided to consumers.
An essential part of this is that continuous improvement is made a priority and that this is communicated throughout all levels of the organisation. Easier said than done!.
This is because a cultural change is required to go from reactive practices (‘fire fighter’ mode) to the more proactive, ‘how can we do better’ approach that allows the improvements that are needed to occur.
Equally as important is the involving of all parts of the organisation in continuous improvement, including supporting consumer participation.
When exploring the definition of governance, traditionally it may be associated with only corporate areas of an organisation including financial, quality, workforce and regulatory compliance.
In the Aged Care Quality Standards, this meaning needs to be widened to include an accountability that ensures effective organisation-wide governance systems are in place for areas relating to risk management, feedback and complaints and a clinical governance framework.
Spotlighting Clinical Governance, it is essential to understand the clinical complexity of consumers and the need to deliver a standard of clinical care and services that is underpinned by current evidenced-based practice.
Essentially, clinical governance has three core areas of purpose:
1. Safety of care or the providing of health care without experiencing preventable harm
2. Appropriateness of care or evidenced-based care
3. Effectiveness of care, which includes evaluation across all parts of the care, underpinned by meaningful partnerships between consumers, and healthcare providers.
In practical terms, the outcomes of governance systems need to ensure capacity to assess, monitor and drive improvements, underpinned by risk management systems to prioritise change and produce the quality of experience for consumers. Robust communication systems supported by policy and procedures and shared to all levels of the organisation are essential to ensure a collective understanding of strategic objectives in line with the practices of the workforce.
