Application of clinical governance in a role 2E hospital: The 2nd general health battalion experience

Improvements in clinical governance in Australian Army health services in recent years have reflected and drawn upon developments in the civilian sector. This paper describes how 2 GHB adapted and incorporated key civilian health system measures to drive improvements in the quality and safety of clinical care. Health restructure initiatives included optimisation of corporate and clinical governance by introducing a Director of Clinical Services to assist the Commanding Officer, a similar structure for technical and command authority to that found in modern civilian hospitals. A Clinical Governance Framework was introduced to provide a platform for identifying and addressing areas for improvement, acknowledging that the delivery of health care endeavours to meet the expectations inherent in the Australian standards while taking place in a unique and often austere environment with no readily comparable Australian civilian benchmark. The framework included a dedicated process to evaluate and improve clinical services based on the National Standards promulgated by the Australian Commission for Safety and Quality in Health Care with a view to achieve external certification of a deployable R2E capability. Clinical governance measures were intensified in 2015 as part of preparations for the deployment of a R2E to Operation OKRA, Australia’s support to Iraq in combating Da’esh. These measures included intensive, realistic clinical training and collective certification exercises (HOSPEX) evaluated by expert independent assessors. During Operation OKRA the Clinical Governance Framework was tailored to meet the challenges of health care in a specific operational setting.