Clinical Governance in Remote Medical Care: role & relevance
To mark the appointment of Stephen Benbow as Head of Clinical Governance and Professional Development at Medilink International, we take look at the importance of this critical aspect in the delivery of remote medical services. Stephen brings to Medilink over 30 years’ experience in pre–hospital, critical care and emergency medicine, having worked on every continent and environment we operate in.
Here, Stephen gives us an insider’s view of the vital role played by clinical governance in ensuring the delivery of the highest possible standards of medical care to our clients. Stephen’s role is to not only audit our work in the field, but also, importantly, to raise the bar on the systems and procedures we have in place. Clinical governance, while a behind-the-scenes aspect of our operations, is however one of the most mission critical in the whole chain of our service delivery.
Why choose a career in clinical governance?
Having worked for many years in remote healthcare, I have experienced a vast range of clinical support systems from various providers. While most are effective in ensuring clients’ needs are met on a daily basis, a number fail to provide the best outcomes for patients at critical times. From auditing cases, I can see that where care has failed, both providers and clients are operating to outdated, even at times obsolete systems and have simply not moved with the times. Identifying and addressing these issues to ensure the ultimate client – the patient – is better served is what motivates me in my career in clinical governance. My aim is to ensure that our clients have the best possible systems in place, and, by constant auditing of those systems, that we at Medilink deliver the highest standard of medical care.
What will your approach be in your first month?
It is clear to me that Medilink International has adopted an evidence-based approach in the management of patients and this, for me, is at the forefront of patient safety. I want to look at all policies and procedures and listen to the clinician’s understanding of situations.
How would you improve patient safety?
The first aspects to look at and review are our current practices, and then to see about making changes by developing new protocols or guidelines based on our operational experience. Also, I’d stress the need to highlight evidence-based current practices. I am here to ensure we implement and respect relevant guidelines, such as those from National Service Frameworks and other international standards, to ensure optimal care when they are not superseded by more recent and more effective treatments.
How do we ensure we remain current within the industry?
Being involved in a special interest research group at the Royal College of Surgeons of London and by being a council member on the Institute for Remote Healthcare (IRHC) helps us in conducting research to develop the body of evidence. By having this pool of research and evidence available, we are able to enhance the level of care provided to future patients. Additionally, we can keep up to date in our field by attending conferences and seminars as both a speaker and by being party to evidence presented by our peers.
Do you see your role therefore as mainly administrative and research based?
No, not at all. I will be revisiting every aspect of the operations within the company, both formal and informal, as part of my auditing role. Only by being hands on in this way can I oversee a thorough auditing process. This is key to ensuring that clinical practices are continuously monitored and that deficiencies in relation to set standards of care are remedied so that we can mitigate both risk to the patient and the company. The auditing, don’t forget, can also be of a third-party provider that we use in our delivery; I am thinking here, for example, of an aircraft deployed for medevac.
Can you explain more about risk management?
Having worked upstream and downstream within both clinical and safety positions I have learnt that risk management involves having robust systems in place to understand, monitor and minimise the risks to patients and staff and also to learn from mistakes. Previously, I was a health and safety manager for a Formula 1 team and then moved into aviation safety ensuring that the team was compliant with International Civil Aviation Organisation (ICAO) codes. As a certified trainer with the UK Civil Aviation Authority, I learnt a lot about the role played by human factors and how most incidents and accidents can be avoided if the right measures are in place up front.
Mistakes are made though, so how do you factor in plans to deal with them?
It’s important to get all the facts in hand and be pro-active in learning from mistakes. Clinical governance is all about being able to model response scenarios from evidence and ensuring all issues, small and large, are reported systematically. Only in this way can we move forward wiser and stronger, and ensure any complaints are handled responsibly by the clinical governance team.
By assessing the failures, we can identify their likelihood of reoccurrence and their level impact if the incident does occur again. Often, the problem can be resolved with education and development of a new set of appropriate systems and checks and balances.
Tell us a little about your background in education and development.
I worked for Robert Gordon University in Aberdeen within the remote healthcare programme and have been a clinical tutor for international post-graduate paramedics with London Ambulance Service. In my experience, I’ve found that providing the best support to enable staff to be competent in their jobs, and to develop their skills so that they are up to date, is key to the success of any organisation.
How will you implement an education and development programme at Medilink?
Continual professional development requires a commitment to lifelong learning. In practice, it’s not always easy for doctors, nurses and paramedics to attend courses and conferences so I will be looking into blended learning. In addition, I will be ensuring that there are regular assessments and in-house workshops to ensure that training is appropriate and meeting our operational needs. We will need to carry out regular and routine appraisals as a means of identifying and discussing weaknesses and opportunities for personal development.
What else will you bring to the company?
The patient experience is very important. Let me give you an analogy: when you go to your regular coffee store, you’re there not just for the great coffee but also for a variety of other experiential reasons such as the comfy chairs, or their great customer service and speedy Wifi. Our patients are similar in making their choices; they want to experience excellence of service, coupled with being treated with dignity and respect.
By ensuring that the services we provide suit the patients, and that patient and client feedback is used to improve services day-to-day, we demonstrate that we are listening to our clients and taking action to deliver raised service levels. It is vital to ensure that we take patient and client needs into consideration across the board, in all our service delivery and that we monitor the outcome of treatment delivered and take evidence-based action on those outcomes. My role therefore is to ensure that we carry out that level of 360 degree customer service assessment and filter our findings back into improving every aspect of our medical support services.