Four clinical governance rabbit holes to avoid

Australasian Institute of Clinical Governance (AICG)​

​​Dr Cathy Balding

​​All human service sectors experience turning points. The 1990s was a decade of revelation about poor healthcare quality, identified and reported in major studies of adverse events and public inquiries worldwide. The initial shock waves evolved into a care safety revolution, supported by the introduction of clinical governance. A quarter of a century later, the outcomes of the Aged Care Quality and Safety Royal Commission are having a similar impact in aged care, with a stream of legislation and innovations challenging aged care providers to re-set their approach to creating and maintaining quality care. 

​The financial cost of suboptimal care to consumers and organisations is significant. [1] Ineffective clinical governance processes also waste time, energy and resources. Expectations are growing that aged care will develop more sophisticated, whole-of-organisation approaches to improving point-of-care quality. The sector can short-cut development time and increase implementation effectiveness by learning from the healthcare sector's clinical governance path. Healthcare has developed many useful and innovative approaches to clinical governance. There have also been many missteps that slowed or misdirected progress. This paper highlights four key clinical governance implementation' rabbit holes' derived from the healthcare experience: 

  1. ​Activity without purpose 
  2. ​Process before people 
  3. ​Prioritising passivity 
  4. ​Confusing fads with foundations. 

​These are not the only clinical governance traps to avoid, but they are useful to be aware of because most: 

  • ​Health services have fallen into these traps on their implementation path at some stage, 
  • ​Align with the literature on clinical governance failures and fault lines, and  
  • ​Are avoidable. 

​Aged care provider organisations have it within their power to bridge these clinical governance chasms because they are not government policy or funding-dependent but require boards and executives to cultivate the right mindset, knowledge and leadership to chart a better course. 

​Find out more about avoiding common issues during the implementation of clinical governance in aged care by accessing the Four Clinical Governance Rabbit Holes to Avoid - Learning from Healthcare to Accelerate Aged Care Clinical Governance Effectiveness article from the Australasian Institute of Clinical Governance (AICG) website. 

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care. 

  1. ​Australian Commission on Safety and Quality in Health Care. The state of patient safety and quality in Australian hospitals 2019. Sydney (AU): ACSQHC; 2019. 
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