In aged care, delivering safe, high-quality care is not just a goal—it's a responsibility. Good clinical governance is critical in ensuring the systems, processes, and culture needed to provide optimal care for older people.
Aged care is a complex environment. To make matters more complex, the requirements for accreditation continue to evolve as the Standards are refined. While this is a good thing for the sector and for our older people, it can make it difficult for professionals working in aged care to understand how to operationalise the standards.
An understanding of clinical governance will help organisations deliver on almost every aged care standard. By giving our teams the tools to think critically about the person they are giving care to and the systems that support that care, we can start to transform our thinking from the standards being the gold standard of care, to the standards being the minimum level of care we will accept.
What is Clinical Governance?
Clinical governance, care governance, service governance - however you refer to it, clinical governance is a concept by which all staff (clinical and non-clinical) share responsibility and accountability for safe and quality care. It ensures systems and processes are in place to provide safe, high-quality, and person-centered care. It involves clear accountability, continuous improvement, effective leadership, and managing risks to protect residents.
For those working in aged care, clinical governance means fostering a culture where the well-being, dignity, and preferences of older adults drive every decision, ensuring care is delivered with respect, consistency, and excellence.
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I am responsible
AICG embraces the mantra "I am responsible" when it comes to clinical governance. This reflects a culture where everyone in the organisation—whether directly or indirectly involved in resident care—takes personal ownership of their role in ensuring the well-being and safety of every resident.
This story is a great example of how ownership is compromised when responsibility is diffused among multiple individuals.
What we do isn't always clinical. So why is it called clinical governance?
It’s true that much of what happens in aged care isn’t strictly clinical, but clinical governance goes beyond clinical tasks—it’s about ensuring the overall quality and safety of care. In aged care, this includes not just healthcare services but also the systems, processes, and culture that support residents' physical, emotional, and social well-being. Whether it’s managing risks, improving communication, or ensuring compliance, clinical governance provides a framework that applies to all aspects of care delivery, making it highly relevant to aged care settings.
I'm not a clinician. Do I need to understand clinical governance?
Yes, understanding clinical governance is important for everyone in aged care, not just clinicians. AICG’s mantra, “I am responsible,” emphasizes that every person, regardless of their role, contributes to the quality and safety of care. Whether you’re a manager, support staff, or work in an administrative capacity, your actions play a part in creating a safe, effective, and supportive environment for residents. Clinical governance is about fostering a culture where everyone takes ownership of their role in ensuring residents’ well-being, recognizing that quality care is a shared responsibility.
What are the risks of not having strong clinical governance practices in aged care?
Without strong clinical governance, aged care organisations risk poor resident outcomes, increased incidents of harm, and non-compliance with regulatory requirements. This can result in reputational damage, financial penalties, and even loss of accreditation. Weak governance may also lead to staff disengagement, inefficient operations, and a lack of accountability, ultimately compromising the safety and well-being of residents.
How can we implement clinical governance in a small or resource-limited aged care facility?
Implementing clinical governance in smaller facilities starts with building a culture of responsibility and continuous improvement. Focus on simple, scalable systems, such as clear reporting lines, regular training, and accessible policies. Engage all staff, encouraging them to take ownership of quality and safety. Use existing tools, such as risk assessments and incident reporting templates, and prioritise actions based on the most significant risks to resident care. Partnering with external organisations like AICG can also provide education and training resources.
How do we create a culture of accountability and responsibility under clinical governance?
Creating this culture starts with leadership commitment to the mantra “I am responsible.” Leaders should model accountability and recognise contributions from all staff. Provide ongoing education about the role of clinical governance in aged care and make responsibilities clear through transparent policies and procedures. Encourage open communication, where staff feel safe reporting issues or suggesting improvements. Recognise and celebrate examples of accountability and foster team collaboration to reinforce the importance of shared responsibility.
Train your team in clinical governance
AICG can provide team training to build clinical governance capability through your organisation. Speak to one of our team members to discuss training for your team.
This is part of a series of resources about clinical governance in aged care that aim to help aged care providers meet their responsibilities for ensuring the quality and safety of clinical care. This fact sheet is for people responsible for developing a clinical governance framework for an aged care service.
The Knowledge and Implementation Hub has gathered evidence on why clinical governance matters in aged care, along with learning and practical resources. These knowledge packages can support the aged care workforce in delivering safe, high-quality care to older Australians. If the concept of clinical governance is new to you, this short click-through learning module provides a simple overview of its role and value to the aged care organisation.
Health is a broad concept, influenced by a range of determinants – psycho-social, environmental, cultural, spiritual (for example). Any care or services can impact a person’s health. Therefore, the concept of clinical governance (which aspires to achieve optimal health outcomes - and therefore quality of living) is as relevant to home care as it is to residential aged care, despite different contexts and priorities. This article dives into building a clinical governance framework that takes direction from the Revised Aged Care Quality Standards (Strengthened Quality Standards), as it relates to aged and home care.
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The Registry of Senior Australians (ROSA) have released its latest ROSA Outcome Monitoring System (OMS) report, a quality and safety monitoring and benchmarking system designed to promote quality improvement, transparency, and accountability for the aged care sector.
The NDIS Independent Advisory Council’s (the Council) paper ‘choice and control to safely live a good life of belonging and citizenship’ recognises the system-wide focus on improving supports for people with disability who are at risk of harm. In response to this paper, the NDIA committed to developing a NDIA Participant Safeguarding Policy (Policy) to guide and enhance the way the NDIA works with NDIS participants and people with disability.
Just because people may be older and potentially frailer doesn't mean that decision-making should be taken away from them. Use this facilitator guide to support discussion about dignity of risk in aged care.
Dignity of risk is another way of saying you have the right to live the life you choose, even if your choices involve some risk.
This Perspectives Brief from the Australian Healthcare and Hospitals Association’s Deeble Institute examines approaches to observations of the Royal Commission into Aged Care Quality and Safety. The authors of this Perspectives Brief note that the Royal Commission ‘identified the need to improve the delivery of health care to meet the needs of older persons and their carers’ and that the ‘greater involvement of older persons and their carers in research to develop solutions was recommended.’
The East London NHS Foundation Trust (ELFT) has dived deeply into partnering with consumers for service improvement. ELFT provides mental health and community services to a diverse population in over 100 community and inpatient sites.
This aged care reform roadmap provides an indicative timeline for key reform elements.
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