Establishment and Implementation of Clinical Governance in Orthopaedic Ward at Jacarta Hospital - Case Study Example

Establishing and Implementing Clinical Governance in an Orthopaedic Ward (Jacarta Hospital) Student’s Name: Instructor’s Name: Course Code: Date of Submission: Introduction Clinical governance is a very important aspect in a clinical setting. This is because it plays a very significant role in enhancing the patient safety and the overall clinical service quality. This is critical in winning the customer satisfaction my matching their expectations with what is provided in the hospital. Clinical governance can be considered to be an integration of different systems, teams, decision-making processes and management and organizational framework in such a way that both the clinicians and the administrators are able to work together and discharge their clinical responsibilities in a responsible manner. As could be provided for, in clinical governance, all the bodies that are involved have the responsibility of demonstrating a sound strategic and leadership with regard to clinical safety and quality ensure that proper safety and quality measures are put in place and also to be accountable of safety and quality issues in service delivery to the patients (Zychowicz 2003). In this paper, will be a detailed presentation of clinical governance in the H ward at Jасаrtа Hospital. This is an orthopaedic ward with a capacity of 30 beds. While this is easy for one to assume that an orthopaedic ward is like any ward, this could not be true to some extent. This is because the ward deals with people that have suffered joint dislocation as a result of accidents. In this case therefore, special attention is actually required to ensure that the injuries are not enhanced but rather have them managed by the clinicians. The paper outlines the various policies, governance issues and other related plans that have to be put in place to ensure the patients in the orthopaedic ward are well handled. Clinical governance in the orthopaedic ward As already identified, clinical governance is used as a tool in the clinical setting in order to help clinicians and the administrators to move from the mid-ranged service provision levels to high quality services as recognized by the available standards in the law and other conventions. In this respect therefore, designing a comprehensive clinical governance policy, will help address various issues which the patients are more concerned about (Chappell and Drenkard 2010). The attention of this document is in four specific areas which include: customer value, clinical performance, clinical risk and management, and professional development and management. Consumer value The first concern in the ward will be about what the consumer who in this case are the patient values (Jim et.al 2007). The clinical governance in the ward will take into account the concerns of the consumers who are key stakeholders in the hospital and need to be involved in the process of enhancing the quality of services that are provided to them. The process of involving the consumers will require a high level leadership to deliver a positive outcome to the whole population (Bullou 2003). However to achieve this outcome, there is need to create a multidisciplinary team structure that will comprise individuals from stakeholder teams. This is to help promote opinion sharing and idea building. The key elements of consumer value that will be taken into consideration in managing the new ward are consumer liaison and consumer participation. The consumer liaison will entail the process of reviewing all the strategies that are put in place there is a two-way communication between clinicians and the patients (Griffin & Potter 2006). This is especially important in ensuring that the consumers are allowed to make informed consents especially when some surgery is being administered. Two-way communication is also important in managing complaints, carrying consumer satisfaction surveys and providing general information about the patients, their family members and carers that can be used to make informed decisions when administering health services to the patients in H ward (Greene 2006). On the other hand, consumer participation entails the process of involving the consumers in the planning activities and policy development as well decision-making in the clinical setting (Carmichael and Goucher 2006). In the orthopaedic ward, consumer participation is used as a strategy to instill confidence among the users of the health services and also the services are administered in an equitable manner. This is because they have a role to play in determining how the services should be determined and made available to the patients (Kotter 1995). Clinical performance and evaluation It is the intention of every hospital to ensure that all the services that it provides are of high quality and are provided under safe conditions (Elwin et al 2006). This is because patients’ safety and health is paramount as it will affect their performance and the overall performance of the health care facility. In the orthopaedic ward, the concern will be how to performance of the nurses working in the ward is enhanced and that appropriate measures to monitor and determine the levels of performance have been established. The intention of putting a clinical performance and evaluation in place is to ensure proper introduction, use and monitoring as well as evaluating evidence-based standards in the orthopaedic ward (Lewis et al 2006). The three specific tools that will be used to realize this goal include: Clinical Standards and clinical performance indicators as well as clinical audit. Through the clinical standards, in the ward, different clinical guidelines will be incorporated alongside different systems and practice protocols. The reference to these standards will be made from the Cochrane Collaboration or from any other reputable specialist group that has been accredited. This is to ensure that the standards are not merely a mention but something based on evidence as the information will have to be published (Maher et al 2002). In addition to this, the clinical indicators in this orthopaedic ward will be used to compare health services being provided with other similar facilities elsewhere and in reference to the required practice. The process will also be supported meaningful and clear reflection of the required standards of service in the orthopaedic ward that could be used in H ward in Jacarta. Finally, the other key element in the clinical performance and evaluation is the clinical audits. This is the process of evaluating to determine the areas of weakness that need to be improved. In the ward, auditing will be a compulsory thing that will be done on a regular basis. This is important in analyzing to determine the level of quality of the services that are provided in the ward (Staheli 2003). Further, the audit will also take care of the outcomes, the procedures used, utilization of resources, diagnosis and treatment procedures as well as the impact of the clinical services in improving the quality of life of the patient. Clinical risk and management It is absolutely important to guarantee the safety of the patients and the clinicians by minimizing all the possible risks that will put the life of individuals at risk (Miller 2004). In the orthopaedic ward where perhaps extra care is required given the nature of medical cases, frequent examination of the possible risks will be highly recommended. This is to determine the causes and the factors that contribute to them and the overall impact on the delivery of health services to the patients in the orthopaedic ward. Some of the most important aspects that are to be considered the clinical risk management in the ward are: incident reporting, monitoring and analysis, sentinel incident reporting, monitoring and investigation and risk incident profile analysis (Hadjistavropoulos et al 2009). To start with, incident reporting, monitoring and trend analysis, such activities as learning local incidents, the frequency and how they have managed, will be carried out to predict the likely incidents and how they can be mitigated so as to ensure maximum safety both for the patients and the nurses. This is because all possible risks are likely to be identified. On the other hand, sentinel incident reporting, monitoring and investigation, will entail the process of identifying, reporting and investigating an anticipated events as prescribed by the Department of Health Policy. The concern that is addressed by this aspect is the determination of the possibility that a certain sentinel incident that pose safety risks to the ward occupants will occur and the possible remedies or mitigation strategies that can be used (Watters and Moran 2006). Finally, in clinical risk and management, there is an aspect of risk profiling analysis. This comprises the process of identifying, investigating, analyzing and evaluating the various risks that are likely to take place in the ward and then determining the best method that can be used to correct or eliminate it. This is important when it comes to finding alternative solutions to any risk that may occur in the ward. This is important in controlling any infections that may attack the patients as a result of being mishandled. This is because some of the fractures could be exposed and as such exposed to the risk of being infected by opportunistic diseases (Harper et al 2007). Professional development and management It is very critical that the selection and placement of the nurses on the orthopaedic ward will have a direct impact on the quality services to the patients (Langley et al 2009). This is because the nurses need to have diverse knowledge, skills, competencies and experience in the area (Maryann 2006). However, demonstrating a high level of competence in the delivery of services, the focus will be in the recruitment process and the requirements that one must attain to be considered suitable working in the orthopaedic ward. The process of maintaining the professional standards of the nurses, their control and monitoring of new, creative and innovative procedures, will be used to ensure that the ongoing recruitment process is considerate of the required skills and experience (Harper et al 2007). This is the reason as to why a comprehensive selection interview will be used when appraising the nurses who will work in the ward. Area of specialty, experience and recommendation are to be taken very serious in getting the workforce to work in the ward. This is important in ensuring that diverse skills and experience that will promote creativity and professionalism have their way in the ward (Kneale & Davis 2005). Implementation of clinical governance Clinical governance in the contemporary health sector is considered as one of the many areas that need some reforms. This is because they affect the overall performance of the health care facility, efficiency and customer satisfaction (Lydia 2006). This is the reason as to why the above four areas of clinical governance that need special attention in the orthopaedic ward have been identified. While the process of implementing the policy document on clinical governance is a responsibility of everyone, to ensure continued support and participation, a clinical governance team will be formed that will oversee the following responsibilities: Developing a well co-ordinated structure that supports the clinical practice using an appropriate methodology that is acceptable across the health care facility. Developing and continuous monitoring of the various performance indicators that cover the decision-making process and delivery of health services to the orthopaedic patients. Monitoring and reporting progress in relation to the established practice frameworks of the hospital and at the departmental level. Disseminating of clinical improvements to the different stakeholders for comment and approval. Conclusion In the document, two important aspects of clinical governance in the orthopaedic ward in the Jacarta Hospital have been discussed. The two aspects are: the establishment of clinical governance and the implementation part of it. In the orthopaedic ward such issues as health and safety of both the staff and patients are of essence and need continuous attention since if not carefully handled can detract the delivery of quality services to the patients which is the core objective of the hospital. Clinical governance addressed four main issues which include: customer value, clinical performance, clinical risk and management, and professional development and management. The recommended way to go about implementation is by a Clinical Governance Team. References Bullough, P. G. (2003). Orthopaedic pathology (4th ed.).St. Louis, MO: Mosby. Carmichael, K.D. and Goucher, N. R. (2006). Orthopaedic Essentials. Journal of Orthopaedic Nursing. 25(2):137- 139. Chappell, K, and Drenkard, K. (2010). Credentialing: Achieving quality in continuing nursing education.The Journal of Continuing Education in Nursing. 41(7):292-293. 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