Dr Melanie Tan
Independent Clinical Governance and Medico-legal Consultant, Dr Melanie Tan Consulting


Dr Melanie Tan is an Independent Clinical Governance and Medico-legal Consultant. With experiences as a medical practitioner (in acute care), lawyer (in aged care, health and medical negligence), and co-carer at home, Melanie offers a unique yet common-sense approach to contemporary clinical governance.

As a CHIA (Certified Health Informatician of Australasia), Melanie also understands how health technology impacts clinical governance, and how clinical governance supports health technology.

Melanie assists providers across all sectors to deliver the best care and support they possibly can (simultaneously mitigating medico-legal risks). In doing so, she helps identify, define and resolve complex issues at the intersection of law, medicine, care and governance, taking an independent and objective view.



What does ‘clinical governance’ mean in home services – and why does it matter?

In this age of change the concept of clinical governance is gradually attracting attention in home care, having been identified by the Aged Care Quality and Safety Commission as one of the ‘5 Key Areas of Risk’ for quality and safety in home services.

Now, not only is clinical governance a specific requirement in the Strengthened Aged Care Quality Standards (Outcome 5.1), but ‘clinical care’ is acknowledged to encompass ‘prevention, treatment and management, optimising quality of life, reablement and maintenance of function’ (Outcome 5.4). Therefore, the concept of clinical governance is no longer limited to care provided by regulated health practitioners – this is an antiquated proposition which applies a restrictive understanding of wellness, and ignores the proven importance of social and cultural determinants of health.

But what does ‘clinical governance’ mean in contemporary home services? And why does it matter so much?

Providers of home care or ‘light’ CHSP services often struggle with the meaning of clinical governance and how it applies to them in the home or community – especially if they are not clinicians. The starting point is to understand that any care, services or support provided in the sanctuary of a person’s home, or in their community, has the potential to influence their health and well-being – and ultimately, clinical outcomes.

Clinical governance is about how we do what we do, everyday. It gives us an approach – a mindset – to deliver the best care and support we possibly can, in a consistent manner while improving on a continuous basis. And of course, it will minimise the risk of harm, and the risk of undermining a person’s experience of living.

But that’s not all. Good clinical governance will also support compliance with the Strengthened Quality Standards – which should inform your clinical governance framework.

In this presentation, Melanie will illustrate what ‘clinical governance’ means in the context of home services, and why it’s so important – even if you don’t provide any clinical care. She will explain how clinical governance aligns with the Strengthened Quality Standards; and finally, describe some real-life examples of failures in clinical governance at home, and their consequences.