Sonya Preston - Clinical Governance within a Community Child & Youth Health Nursing Context


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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. 1. Clinical Governance within a Community Child and Youth Health Nursing ContextPresentation by Sonya Prestonon Wednesday 24 October 2012
  2. 2. Clinical Safety and Quality Governance Framework in Hospital and Health Services Sets out the fundamentals of aframework Provides guidance on establishing thesystems, processes and behavioursReference: Queensland Health. 2012. Clinical Safety and Quality GovernanceFramework in Hospital and Health Services. State of Queensland (Queensland Health).
  3. 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 Safetyand QualityReference: Queensland Health. 2012. Clinical Safety and Quality Governance Framework inHospital and Health Services. State of Queensland (Queensland Health).
  4. 4. Planning forSafety and Quality
  5. 5. Planning for Safety & QualityClinical Governance Plan developed, implemented& monitoredOperational plan reflects safety & quality objectives90 Day action plans include quality initiatives andrisk mitigation strategiesKPI’s measure quality & safety processes andoutcomes
  6. 6. Planning for Safety & QualityPAD processes monitor implementation of safetyand quality objectives.Service agreements are inclusive of safety &quality processesClinicians engaged in determining the safety &quality priorities for the service through monthlyprocesses that identify local risk priorities.
  7. 7. Planning for Safety & QualityAll services are supported by IHW to ensure culturally safeservices & facilitate consumer engagement leading to futureplanning processes.Clinical governance implementation progress is tabledquarterly utilising traffic light system.Investment in safety culture through implementation ofquality & safety training initiatives such as Caps,(Communication and Patient Safety) PRIME CI & CF (PatientRisk Information Management and Evaluation Clinical Incident& Consumer Feedback), TMS (Team Management Systems)
  8. 8. Planning for Safety & QualityIdentified the key service challenges withinstrategic plan by monitoring trends through safety &quality reporting systems.
  9. 9. Action forSafety and Quality
  10. 10. Action for Safety & QualityEach role description includes duties,responsibilities & accountabilities that reflect a safetyculture.Organisational structure supports delegation ofaccountabilities associated with quality & safety.Safety & Quality Committee established with acomprehensive committee structure.
  11. 11. Action for Safety & QualityImplementation of a clinical incident managementprocess.Application of the clinical service capabilityframeworkConsumer feedback & complaints managementprocessImplementation of clinical audit & review process
  12. 12. Action for Safety & QualityRegistration, Credentialing & Scope of Practiceprocesses for regulation compliance.Mortality & morbidity reviewCritical incident review committeeClearly defined delegations regarding safety &quality decision making within service
  13. 13. Action for Safety & QualityService agreement clearly identified responsibilitiesfor safety & quality.Safety & Quality Committee effectiveness isreviewed annuallyKey performance indicators are reported monthlyutilising traffic light processKey performance indicators are identified throughservice re-design processes.
  14. 14. Action for Safety & QualityIdentified integrated risk management procedureAll project plans, business cases and issuespapers include a risk management plan.All staff have access to training on riskmanagement
  15. 15. Balanced Monitoring for Safety & Quality
  16. 16. Balanced Monitoring for Safety & QualityActively monitor key performance indicators andcompare against other like service benchmarks.Measurement of clinical quality is achieved throughthe implementation of clinical performanceassessment toolFormalised case conferencing and peer groupsupervision is undertaken within each service
  17. 17. Balanced Monitoring for Safety & QualityEnsure compliance with accreditation bodies andNational Standards.Internal clinical auditing including scheduled andspot audits.Clinical practice reviews undertaken and serviceintervention based on scientific knowledge.Waiting timeframes monitored and minimisationstrategies implemented.
  18. 18. Balanced Monitoring for Safety & QualityLEAN thinking strategies implemented at all servicelevelsBoth lead and lag indicators are identified todetermine risk management processesReview of data collection and auditing processes toensure usefulness of data.
  19. 19. Balanced Monitoring for Safety & QualityTargeted clinical audits that are meaningful to theclinical service provisionEnsure appropriate sampling and datameasurements.
  20. 20. Appraisal, Learning and Action for Safety & Quality
  21. 21. Appraisal, Learning and Action for Safety & QualityMonitor compliance against the Hospital & HealthService readiness report in 12 months.Thoroughly investigate potential areas of concernsuch as issues identified in practice reviews,complaints and risks.Implementation of education and training
  22. 22. Appraisal, Learning and Action for Safety & QualityCultural practice training by Aboriginal & TorresStrait Islander consumerEscalation for reporting outcomes and risksImplemented plan do check act cycle to ensureactions & priorities are incorporated into planningcycle
  23. 23. QUESTIONS