Governance, leadership and culture

Action 1.01
The governing body: Provides leadership to develop a culture of safety and quality improvement, and satisfies itself that this culture exists within the organisation Provides leadership to ensure partnering with patients, carers and consumers Sets priorities and strategic directions for safe and high-quality clinical care, and ensures that these are communicated effectively to the workforce and the community Endorses the organisation’s clinical governance framework Ensures that roles and responsibilities are clearly defined for the governing body, management, clinicians and the workforce Monitors the action taken as a result of analyses of clinical incidents Reviews reports and monitors the organisation’s progress on safety and quality performance.

Action 1.01

The governing body:

Provides leadership to develop a culture of safety and quality improvement, and satisfies itself that this culture exists within the organisation
Provides leadership to ensure partnering with patients, carers and consumers
Sets priorities and strategic directions for safe and high-quality clinical care, and ensures that these are communicated effectively to the workforce and the community
Endorses the organisation’s clinical governance framework
Ensures that roles and responsibilities are clearly defined for the governing body, management, clinicians and the workforce
Monitors the action taken as a result of analyses of clinical incidents
Reviews reports and monitors the organisation’s progress on safety and quality performance.

Provide leadership on reasonable adjustments as a part of the safety culture

Leadership and culture development that supports positive attitudes towards people with intellectual disability requires clear leadership. Reasonable adjustments are essential components of safety and quality.^[41]^,^[42] This can include encouraging the commitment to accessibility by producing Easy Read versions of key organisational documents that support access to important information about health care.

The health service organisation’s leadership should increase the visibility of healthcare strategies to improve outcomes for people with intellectual disability, by developing a disability service plan, providing training and collecting demographic data to identify people with intellectual disability. The Metro South Health Disability Service Plan 2023–26 is an example of a disability service plan.

Involve people with intellectual disability, and their family, supporters or guardians in describing their experience of health care and respond to the issues identified

It is important to consult people with intellectual disability as part of organisational planning, monitoring and review, and to have systems in place for identifying safety and quality issues for people with intellectual disability.

It is also important to involve people with intellectual disability and their supporters in reviewing and assessing their experience of care. The Commission’s Australian Hospital Patient Experience Question Set – Easy English for people with low English literacy is a survey hospitals and healthcare services use to ask recent patients about their experiences of treatment and care. It is based on the aspects of treatment and care that patients in Australian hospitals and healthcare services have told the Commission are most important to them.

A person with intellectual disability, and/or their family supporter or guardian, could describe to members of the governing body their experience of the following aspects of care:

Before going to hospital	During hospital stay	After leaving hospital
Parking Signage Reception Filling out forms Waiting times and areas Pre-admission processes and information Communication needs, gaps and accessibility of information (e.g. Easy Read versions or video animations)	Support during all aspects of admission Understanding of multi-disciplinary approaches Meeting disability support needs during admission Communication between clinicians for transitions of care	Discharge planning Transition of care

Action 1.02
The governing body ensures that the organisation’s safety and quality priorities address the specific health needs of Aboriginal and Torres Strait Islander peoples.

Intent

Strategies for improvement

Incorporate the identification of Aboriginal and Torres Strait Islander people with intellectual disability into the organisation’s demographic profile

Aboriginal and Torres Strait Islander people with disability, including people with intellectual disability, should be identified as a priority group within relevant First Nations health service plans. People with disability are an identified priority group within the National Aboriginal and Torres Strait Islander Health Plan 2021–2031.

Partner with local Aboriginal and Torres Strait Islander communities to develop an understanding of how many local Aboriginal and Torres Strait Islander people have intellectual disability, and their experience of health care. This information can inform the co-design of strategies to address their specific access barriers and health needs.

Data from the 2018 Survey of Disability, Ageing and Carers found that 10.1% of Aboriginal and Torres Strait Islander males had an intellectual disability and 5.9% of females had an intellectual disability. The combined rate for men and women is 15.9%.^[43]

Consult with Aboriginal and Torres Strait Islander health service providers and communities on safety and quality issues for people with intellectual disability

The 2023 Commonwealth Closing the Gap Implementation Plan has incorporated disability into the reform agenda and priority targets. Consult with local communities on culturally inclusive concepts of disability to assist with identifying specific approaches required for Aboriginal and Torres Strait Islander people with intellectual disability.

For more information see:

The First Peoples Disability Network website, which provides background reading and information on effective health care
Data from the 2018 Survey of Disability, Ageing and Carers on Aboriginal and Torres Strait Islander people with disability
The 2023 Commonwealth Closing the Gap Implementation Plan Disability Sector Strengthening Plan.

Action 1.01

Action 1.02