Can a clinical senate enhance state-wide clinician engagement? A survey studyJulie A. Quinlivan A B E , Mary Miller C and Marani Hutton D
A Department of Health, 189 Royal Street, East Perth, WA 6004, Australia.
B Institute for Health Research, University of Notre Dame Australia, 19 Mouat Street, Fremantle, WA 6160, Australia.
C WA Country Health Service, 189 Wellington Street, Perth, WA 6000, Australia. Email: Mary.Miller@health.wa.gov.au
D South Metropolitan Health Service, PO Box 546, Fremantle, WA 6959, Australia. Email: Marani.Hutton@health.wa.gov.au
E Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - https://doi.org/10.1071/AH16110
Submitted: 30 May 2016 Accepted: 28 October 2016 Published online: 16 December 2016
Objective Clinician engagement correlates with quality, safety and efficacy outcomes. The aim of the present study was to explore whether a clinical senate model achieves clinical input into system manager and operational health service boards.
Methods A mixed-methods survey was undertaken. Participants were current or immediate past members of the Clinical Senate of Western Australia (CS). For the 124 surveys sent out, the response rate was 60%.
Results Respondents stated the CS played a role in clinician engagement (95%), contributed to healthcare reform (82%), knowledge of contemporary health issues (92%), feedback to decision makers (82%), clinician networking (94%), debate on important issues (93%), enabled clinicians to work on recommendations to improve health at a state level (87%), contributed to clinician thinking on health reform (88%) and enabled clinicians to share their knowledge (91%). Four major themes emerged in the qualitative analysis: (1) the need for a strong independent clinician forum and voice at a state level; (2) the need to strengthen clinician interactions with operational healthcare boards; (3) a strong belief that clinician engagement strengthened quality and safety outcomes at a state level; and (4) that membership was important and needed to be diverse, multidisciplinary and independent, but structurally representative of clinicians in the state.
Conclusion A clinical senate model can facilitate state-wide clinician engagement.
What is known about the topic? High levels of clinical engagement foster a culture within healthcare organisations that is associated with the delivery of sustained high-quality, safe and efficient services. This has led to a focus on strategies to optimise clinical engagement in healthcare planning and reform. However, there is limited data exploring how to achieve clinical engagement at a state, rather than local, level within the healthcare system.
What does this paper add? This survey study evaluates the effectiveness of the Western Australian clinical senate model in achieving clinical engagement at a state level with regard to the outcomes of quality and safety, planning and reform. The survey findings suggest the clinical senate model is an effective strategy for state-based clinical engagement.
What are the implications for practitioners? Clinical engagement is important. It is necessary to have in place strategies that address not only local engagement within a health service, but also system-wide engagement in order to promote quality and safety, planning and reform agendas at a state level.
Additional keywords: clinical engagement, healthcare reform, quality and safety in healthcare.
References Clark J, Nath V. Medical engagement: a journey not an event. The King’s Fund; 2014. Available at: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/medical-engagement-a-journey-not-an-event-jul14_0.pdf [verified 14 November 2016].
 Clinical Senate of Western Australia. Dial E for engagement – are clinicians on hold? Clinical Senate meeting final report. Government of Western Australia, Department of Health; 2015. Available at: http://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Clinical%20Senate/PDF/Final-report-clinician-Engagement-dial-e-for-engagement.ashx [verified 14 November 2016].
 Dickinson H, Ham C, Snelling I, Spurgeon P. Are we there yet? Models of medical leadership and their effectiveness: an exploratory study. Final report. NIHR Service Delivery and Organisation programme. 2013. Available at: https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CB0QFjAA&url=http%3A%2F%2Fwww.nets.nihr.ac.uk%2F__data%2Fassets%2Fpdf_file%2F0007%2F85066%2FFR-08-1808-236.pdf&ei=NLJSVdHOJOHNmwWlioDIDg&usg=AFQjCNGffPJQp-1sRRSuuY0-8TVld00l5Q [verified 14 November 2016].
 Quinlivan JA, Basile T, Gibson K, Xu D, Croker N. The Western Australian Clinical Senate as a model for state-wide clinical engagement. Health Care: Current Rev 2016; 4 172
| The Western Australian Clinical Senate as a model for state-wide clinical engagement.CrossRef |
 West M, Eckert R, Steward Kl, Pasmore B. Developing collective leadership for health care. The King’s Fund. 2014. Available at: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/developing-collective-leadership-kingsfund-may14.pdf [verified 14 November 2016].
 Healthcare Improvement Scotland. Improving healthcare together: clinical engagement strategy 2014–2017. 2015. Available at: http://www.healthcareimprovementscotland.org/previous_resources/policy_and_strategy/clinical_engagement_strategy.aspx [verified 14 November 2016].
 Australian Bureau of Statistics (ABS). 1306.5 – Western Australia at a glance, 2014. ABS; 2014. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/1306.5 [verified 1 August 2016].
 WA Health. Health Administrative Review Committee. Report of the Health Administrative Review Committee. Perth: WA Health; 2001.
 Clinical Senate of Western Australia. Clinical Senate of Western Australia. 2016. Available at: http://ww2.health.wa.gov.au/Improving-WA-Health/Clinical-Senate-of-Western-Australia [verified 14 November 2016].
 Government of Western Australia, Department of Health. Review of the recommendations of the Clinical Senate of Western Australia Debates. 2014. Available at: http://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Clinical%20Senate/PDF/Review-Recommend-ClinicalSenateofWADebates.ashx [verified 14 November 2016].
 Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008; 62 107–15.
| The qualitative content analysis process.CrossRef |
 Ham C, Timmins N. Managing health services through devolved governance. A perspective from Victoria, Australia. The King’s Fund; 2015. Available at: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Devolved-governance-Victoria-Kings-Fund-November-2015.pdf [verified 14 November 2016].
 Sutcliffe KM, Paine L, Pronovost PJ. Re-examining high reliability: actively organising for safety. BMJ Qual Saf 2016;
| Re-examining high reliability: actively organising for safety.CrossRef |
 Leviton LC, Melichar L. Balancing stakeholder needs in the evaluation of healthcare quality improvement. BMJ Qual Saf 2016; 25 803–7.
| Balancing stakeholder needs in the evaluation of healthcare quality improvement.CrossRef |
 Degeling P, Kennedy J, Hill M. Mediating the cultural boundaries between medicine, nursing and management – the central challenge in hospital reform. Health Serv Manage Res 2001; 14 36–48.
| Mediating the cultural boundaries between medicine, nursing and management – the central challenge in hospital reform.CrossRef | 1:STN:280:DC%2BD3M7lvFGktQ%3D%3D&md5=9577b7aed40ce09e4a92ef1d1c6da2e2CAS |
 Firth-Cozens J. Multidisciplinary team work: the good, bad, and everything in between. Qual Health Care 2001; 10 65–6.
| Multidisciplinary team work: the good, bad, and everything in between.CrossRef | 1:STN:280:DC%2BD3Mzhs1OrsA%3D%3D&md5=962caa5a43068f6e1addb96b5150581fCAS |
 Dickinson H, Bismark M, Phelps G, Loh E. Future of medical engagement. Aust Health Rev 2016; 40 443–6.
| Future of medical engagement.CrossRef |