A presentation given by Sonya Preston at The Journey, CHA Conference 2012, in the 'Delivering Safety & Quality: Innovations in Clinical Governance' stream.
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Sonya Preston - Clinical Governance within a Community Child & Youth Health Nursing Context
1. Clinical Governance
within a Community Child
and Youth Health
Nursing Context
Presentation by Sonya Preston
on Wednesday 24 October 2012
2. Clinical Safety and Quality
Governance Framework
in Hospital and Health Services
Sets out the fundamentals of a
framework
Provides guidance on establishing the
systems, processes and behaviours
Reference: Queensland Health. 2012. Clinical Safety and Quality Governance
Framework in Hospital and Health Services. State of Queensland (Queensland Health).
3. Four High Level Elements
Planning for Safety and Quality
Action for Safety and Quality
Balanced Monitoring for Safety and Quality
Appraisal, Learning and Action for Safety
and Quality
Reference: Queensland Health. 2012. Clinical Safety and Quality Governance Framework in
Hospital and Health Services. State of Queensland (Queensland Health).
5. Planning for Safety & Quality
Clinical Governance Plan developed, implemented
& monitored
Operational plan reflects safety & quality objectives
90 Day action plans include quality initiatives and
risk mitigation strategies
KPI’s measure quality & safety processes and
outcomes
6. Planning for Safety & Quality
PAD processes monitor implementation of safety
and quality objectives.
Service agreements are inclusive of safety &
quality processes
Clinicians engaged in determining the safety &
quality priorities for the service through monthly
processes that identify local risk priorities.
7. Planning for Safety & Quality
All services are supported by IHW to ensure culturally safe
services & facilitate consumer engagement leading to future
planning processes.
Clinical governance implementation progress is tabled
quarterly utilising traffic light system.
Investment in safety culture through implementation of
quality & safety training initiatives such as Caps,
(Communication and Patient Safety) PRIME CI & CF (Patient
Risk Information Management and Evaluation Clinical Incident
& Consumer Feedback), TMS (Team Management Systems)
8. Planning for Safety & Quality
Identified the key service challenges within
strategic plan by monitoring trends through safety &
quality reporting systems.
10. Action for Safety & Quality
Each role description includes duties,
responsibilities & accountabilities that reflect a safety
culture.
Organisational structure supports delegation of
accountabilities associated with quality & safety.
Safety & Quality Committee established with a
comprehensive committee structure.
11. Action for Safety & Quality
Implementation of a clinical incident management
process.
Application of the clinical service capability
framework
Consumer feedback & complaints management
process
Implementation of clinical audit & review process
12. Action for Safety & Quality
Registration, Credentialing & Scope of Practice
processes for regulation compliance.
Mortality & morbidity review
Critical incident review committee
Clearly defined delegations regarding safety &
quality decision making within service
13. Action for Safety & Quality
Service agreement clearly identified responsibilities
for safety & quality.
Safety & Quality Committee effectiveness is
reviewed annually
Key performance indicators are reported monthly
utilising traffic light process
Key performance indicators are identified through
service re-design processes.
14. Action for Safety & Quality
Identified integrated risk management procedure
All project plans, business cases and issues
papers include a risk management plan.
All staff have access to training on risk
management
16. Balanced Monitoring for Safety & Quality
Actively monitor key performance indicators and
compare against other like service benchmarks.
Measurement of clinical quality is achieved through
the implementation of clinical performance
assessment tool
Formalised case conferencing and peer group
supervision is undertaken within each service
17. Balanced Monitoring for Safety & Quality
Ensure compliance with accreditation bodies and
National Standards.
Internal clinical auditing including scheduled and
spot audits.
Clinical practice reviews undertaken and service
intervention based on scientific knowledge.
Waiting timeframes monitored and minimisation
strategies implemented.
18. Balanced Monitoring for Safety & Quality
LEAN thinking strategies implemented at all service
levels
Both lead and lag indicators are identified to
determine risk management processes
Review of data collection and auditing processes to
ensure usefulness of data.
19. Balanced Monitoring for Safety & Quality
Targeted clinical audits that are meaningful to the
clinical service provision
Ensure appropriate sampling and data
measurements.
21. Appraisal, Learning and Action for Safety & Quality
Monitor compliance against the Hospital & Health
Service readiness report in 12 months.
Thoroughly investigate potential areas of concern
such as issues identified in practice reviews,
complaints and risks.
Implementation of education and training
22. Appraisal, Learning and Action for Safety & Quality
Cultural practice training by Aboriginal & Torres
Strait Islander consumer
Escalation for reporting outcomes and risks
Implemented plan do check act cycle to ensure
actions & priorities are incorporated into planning
cycle