Governance

Identifying and engaging clinical stakeholders

To gather clinical requirements, it is important to engage with a range of stakeholders that are likely to use the new system. While the focus is on clinical requirements, it is essential to consider the needs of system experts as well as administrative staff and managers overseeing operations that support clinicians.

Three steps to help identify the right stakeholders

1. Identify relevant user groups: who will use the system, who will it impact or who will see a change in their workflow, and who will manage the system once it is implemented. This may include medical, nursing, allied health, pharmacists and other clinical support staff.
2. Identify representatives across identified user groups: this can be done through a:
   1. Nomination process – work with senior management to nominate users with high influence. These are users who are critical to the success and uptake of the system. For example, staff that will use the system frequently, or staff that are leaders within their teams.
   2. Expression of Interest (EOI) process – use this to identify users with high interest in the system being purchased. An EOI process will increase the success of engagement as these users are willing to be involved and are invested in the outcome of the procurement process.
3. Validate the stakeholders identified are sufficient for your process: this can be done using the following tools:
   1. Stakeholder maps – to identify stakeholders against a matrix such as influence and interest.
   2. Key role maps – use an organisational chart with target groups identified to visualise impacted roles. Reviewing the stakeholder list against the key role map will help validate check that you have included both key users of the system and the decisions makers within the teams.

Clinical governance considerations

A key consideration when gathering clinical requirements is the clinical governance processes and standards within your organisation. Their inclusion is key to success, as these processes and standards drive much of the patient safety and quality procedures, for example the standards for reporting.

Clinical governance is an integral part of the corporate governance of health service organisations. This means any system or technology you are purchasing will need to meet the organisation’s requirements to deliver safe, high-quality and person-centred care.

An example of a clinical governance requirement is the National Safety and Quality Health Service (NSQHS) Clinical Governance Standard. Many services such as public and private hospitals, day procedure services and most public dental practices are required to be assessed against the NSQHS standards. Other healthcare services may choose to be accredited to show their commitment to improving the safety and quality of healthcare.

When purchasing a new system or technology that will be used by clinicians or impact their workflows, relevant standards defined by the Australian Commission on Safety and Quality in Healthcare in the NSQHS standards must be included in the requirements. The ability for the system to meet the standards can impact the organisation’s ability to pass accreditation and ensure there is no loss to funding, reputation or licensing. Vendors should also be asked how they intend to ensure ongoing compliance and continuous improvement of functionality for patient safety and quality.

Identifying and engaging with clinical governance leaders

Clinical governance requirements are complex and require the assistance of subject matter experts (SMEs) to ensure comprehensive inclusion of requirements suitable for your organisation. SMEs can review the list of requirements you gather and identify additional requirements to provide simplified compliance with clinical governance processes.

For hospitals and large centres such day procedure facilities, quality teams are an important group to engage with on clinical requirements. These teams are dedicated to supporting compliance with clinical governance standards and procedures and will have in-depth knowledge on how a system or technology could better support processes. These teams also manage complaints and suggestions from consumers which may provide further insight to how a system could work to avoid current issues.

For community-based healthcare services such as Medical Centres, private allied health clinics and mental health providers there may be a role identified responsible for leading clinical governance processes. Alternatively consider contacting the local Public Health Network (PHN). The PHN has a responsibility to provide support to local health services and often collects data on patient outcomes and quality of care. They may be able to provide some insight into requirements for the new system or technology being procured.

Including clinical governance in the approval process

Large healthcare organisations

Large healthcare organisations are likely to have peak clinical committees. These committed play a key role in the approval process for the clinical requirements gathered for the new system or technology being purchased. The membership of these peak bodies will include clinical leaders within the organisation. These leaders often hold responsibility for patient safety and quality outcomes within the organisation.

If for example the organisation is procuring a Cancer Services electronic Medical Record (eMR) and the organisation has a Cancer Service Clinical Quality Committee, be sure to include it in your approval process for the requirements you gather. This will ensure support and buy-in at the clinical leadership level of the organisation and provide a point of accountability for the requirements that will be delivered as part of the new system or technology.

Small facilities

Smaller facilities may not have a relevant governance structure, in which case it is important to confirm the designated members of staff who are accountable for clinical governance and include them in the approval process for requirements prior to going out to market.