Clinical education in aged care, and across health generally, has traditionally focused on hospital teaching models for individual health profession disciplines such as medicine, nursing and health sciences. It is seen as an essential component of health professional education and critical to ensure quality of patient and client care. More recently a broader approach has been developing across the health sector that takes into account multiple disciplines such as law, psychology and economics, and provides exposure to other clinical settings, including community, primary and residential care.
Associated with this expansion of multidisciplinary frameworks in clinical education is the development of the clinical governance framework and its role in supporting all staff involved in direct or indirect care provision. The Australian Commission on Safety and Quality in Health Care defines clinical governance as the ‘set of relationships and responsibilities established by a health service organisation between its governing body, executive, clinicians, patients and consumers to deliver safe and quality health care’. Similarly, the definition of ‘high-quality care’ as defined by the Australian Commission on Safety and Quality in Aged Care, includes a clinical governance framework in standard eight and how it relates specifically to ‘antimicrobial stewardship, minimizing the use of restraint and open disclosure’.
For aged care organisations in Australia the integration of clinical governance frameworks provides opportunities to develop a robust corporate governance culture where the collective roles and responsibilities of patients, consumers, clinicians, healthcare teams, managers, directors and governing bodies are taken into account. There is evidence that some more innovative aged care organisations in Australia have started integrating the clinical governance framework into their mission and values. This is reflected in the promotion of new senior leadership positions in clinical governance that aim to enculture quality of care and enable continuous improvement in service provision across the organisation.
What is needed now is the development and integration of clinical education models that meet quality standards across all layers of aged care organisations. Models would include the teaching of integrated quality improvement processes across all aged care settings, based on clinical governance principles promoting person-centred care, accessibility, universal entitlement and inclusiveness.