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"Clinical governance is the set of relationships and responsibilities established by a health service organisation between its state or territory department of health, governing body, executive, workforce, patients, consumers and other stakeholders to ensure good clinical outcomes." - Australian Commission on Safety and Quality in Health Care [ACSQHC], 2021

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"Clinical management is an approach to decision-making about all aspects of patient care". - UHN Margaret Cancer Centre 2023

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Patient health outcomes are the results of healthcare services or interventions. They focus on meeting the physical, social, and emotional needs of patients from their own perspective.

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The Australian Commission on Safety and Quality in Health Care plays a paramount role in Australia surrounding clinical governance as they are involved in the National level recommendations for all state and territory health services.

The ACSQHC has developed the National Safety and Quality Health Service (NSQHS) Standards, which "provide a nationally consistent statement of the level of care consumers can expect from health service organisations."

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National Safety and Quality Health Standards

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National Safety and Quality Health Standards

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These standards cover a variety of areas that apply to all healthcare settings, including hospitals, general practices and aged care settings.

The standards include;

Clinical Governance Standard

Partnering with Consumers Standard

Preventing and Controlling Infections Standard

Medication Safety Standard

Comprehensive Care Standard

Communicating for Safety Standard

Blood Management Standard

Recognising and Responding to Acute Deterioration Standard

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The next level down is the state health services. For example; the Canberra Health Services has their own Clinical Governance Policy, which is largely affected by the suggestions made by the ACSQHC. Attached is the policy providing information to all Healthcare workers working under the jurisdiction of ACT Health services.

"The CHS Clinical Governance Framework is based on the Australian Commission on Safety and Quality in Health Care's National Model Clinical Governance Framework." - Canberra Health Services, 2021

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The Canberra Health Services (CHS) has a Clinical Governance policy as included above, which for the most part is a direct representation of the NSQHS standards. Providing the essential information and guidelines that are to be put into practice.

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Surrounding Clinical Management these guidelines need to be applied and enforced in the clinical setting, the way this is delegated is in Action 1.23, where the intent is that; "Clinicians are appropriately skilled and experienced to perform their roles safely, and to provide services within agreed scope of clinical practice."- Australian Commission on Safety and Quality in Health Care [ACSQHC], 2021, 1.23

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The next level beyond the policy to consider is the discipline heads. For example in CHS the Executive Director of Nursing and Midwifery and the Executive director of Medicine, who aim to guide the Health Services in the direction that supports the policy best, considering things like additional ELearning to achieve objectives throughout the ACT, as well as regular 'Huddles' where ward/hospital health outcomes/problems are discussed. The Directors are responsible at the top level for maintaining the standards that start with the ACSQHC, extending to CHS policy, extending to managerial policy.

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The final part of the policy to consider is the actual patient health outcomes that are being observed. What are the trends? Positive? Negative? These are the outcomes that we are seeing directly from the patients. For example when a Physiotherapist assists in the development of muscle function in getting in and out of a car.

"Involving patients in improvement projects can increase the quality of care and help identify completely new ways of providing care." - Sima Marzban (2022)

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Identifying flaws all the way at the Clinical Governance level is how the Health Outcomes get improved in the long run. This meaning each level working down to the patient is consistent in the standards of care. The final health outcomes are generally a result of an interdisciplinary approach that caters to each need from the patient.