It feels like there are countless pieces in an aged care governance jigsaw puzzle box, with aged care leaders on a merry go round of planning, strategizing and reviewing without witnessing the governance in action – the achievement of puzzle completion.

We eagerly start the puzzle with the four corners of corporate governance – clinical, financial, risk and people. We start working along the edges, make some progress, become distracted with another priority. We allot some time, return to the puzzle, pull out some ill-fitting pieces, make some progress from one corner towards the centre perhaps leaving three others exposed and disconnected. With all our best intentions do we tire of the energy the continuous planning, strategising and reviewing takes, do we see the same results in our quality performance because we have not completed the puzzle, or we have thrown pieces back in the box with our hands in the air.

How do we complete the puzzle and witness governance in action? Australian Regional and Remote Community Services the largest aged care provider in the Northern Territory improved their governance systems with two key bodies of work. The first is an alignment of organisational governance and policy framework to the strengthened aged care standards. The second is an actionable clinical governance framework incorporating cultural governance.

ARRCS present you with the foundational work and early successes of aligning the strengthened standards to organisational governance using the new Standard 2 as an example, how linking policy, ARRCS strategic plan, guiding internal frameworks and committee structures, agendas and stakeholders will be the central piece to completing the governance puzzle and witnessing engagement from the coalface, communities through to the ARRCS Board.

ARRCS Clinical Governance Framework has been in action with one revision since 2021. In 2021 ARRCS had 43 unmet criteria across 8 sites. In 2022/2023 standard compliance increased to 62.7 % and in 2023/24 are now 83.7% compliant. The framework has seven core elements: governance, leadership and culture; consumer partnerships; consumer safety and continuous improvement systems; clinical performance and effectiveness, competent and effective workforce, stakeholder engagement and research and innovation. ARRCS present the governance in action deliverables which have contributed to the ongoing improvement in standard compliance and have set us on task for making clinical governance everyone’s business.