How we keep our patients safe

At Juniper, our number one priority is to always deliver safe healthcare — and a lot goes into accomplishing this mission.

From the clinical governance pillars that each and every one of our team members adheres to and the rigorous auditing processes that help us intercept errors before they impact the patient, we’ve worked hard to create a system that puts you and your safety first.

Today, we’re letting you in on this system and all it encompasses. Let’s dive in.

What is clinical governance?

Clinical governance is defined as the set of relationships and responsibilities that ensures a systematic approach to maintaining and improving the quality of patient care across our clinical services.

What this means, in simpler terms, is that through our clinical governance framework, we can ensure that the services we provide to you are as safe as they are effective.

But what does that framework look like?

At Juniper, it all goes back to five key pillars:

1. Organisational structure: Our structures are built so that everyone can take accountability for their role in our mission. 
2. Insights and research: We harness the power of telehealth and data collection to provide integrated care.
3. Risk management: We identify and manage risks at multiple levels to guarantee patient safety (more on this shortly).
4. Performance: We take on feedback and work with our clinical teams and patients to continuously improve the quality of our care.
5. Technical: We strive to create an environment that keeps you (and your data) safe, using the best available technology.

We’re not just up to standard — we’re above it

By keeping these pillars front of mind in every decision we make, we can offer health services that don’t just meet what’s expected in terms of patient safety and quality of care but far surpass it.

In fact, our safety and quality systems are certified by the Australian Council on Healthcare Standards — an accreditation that, to our knowledge, no other telehealth company in Australia has.

How we audit our consults

Every month, Juniper’s parent company (Eucalyptus) audits over 5000 consults at a global scale. Our clinical auditing team, comprised of pharmacists and a doctor breaks these audits down into 6 categories: 

1. High risk: These are consultations that pose a significant potential risk to patient safety, and are monitored every 24-72 hours.
2. New practitioner: Every time we onboard a new practitioner, we manually audit their first 100 consultations to make sure they meet our safety and quality benchmarks.
3. Ad-hoc: These are targeted audits prompted by anomalies, for example, if a practitioner approves too many patients compared to their peers.
4. Random: These are monthly audits that give us a high-level view of what exactly is going on within our clinical services.
5. Quality: These assess consultations against our quality benchmarks to ensure our practitioners are providing a positive patient experience.
6. Multidisciplinary: Our medical support and health coaching teams peer review their patient interactions against our frameworks, as a way to promote growth, trust, and consistency within the team.

Our 4-step process for high-risk consultations

When there is a high risk that a consult will impact a patient’s safety, we need to intervene immediately, and this relies on timely detection. 

To keep the finger on the pulse at all times, we developed a reactive 4-step approach to target decisions with a ‘high-risk’ rating:

1. Risk identification: We started by identifying the decisions practitioners make that carry the highest potential risk.
2. Analytics query: Along with our analytics team, we generated specialised queries to pinpoint the specific risks identified in step 1.
3. Manual audit: If any consults are identified through the analytics queries, we manually review them to assess whether an appropriate or inappropriate clinical decision was made.
4. Actions and feedback: We immediately provide robust feedback to the practitioners and rectify any mistakes before a patient’s medication gets to the pharmacy.

What is our safety criteria?

As a telehealth company, there are some ways our safety protocols are more conservative than those used in traditional healthcare settings and, when we deem in-person treatment to be required or more appropriate, we encourage our practitioners to refer to external providers — like GPs and specialists — as a way to guarantee continuity of care.

Looking at our internal safety criteria, there are two key factors we track:

• Severity, to prioritise the errors that need to be addressed first

Severity outlines the potential harm a decision can inflict upon the patient and it dictates the priority of the initial response from our clinical team. 

Severity ratings range from the highest-priority “never events”, i.e. something that we would never accept to happen, where a decision may cause death or permanent harm, to the least severe “low risk” events where no harm will occur.

• Harm score, to capture the outcome of the decision

This score is based on the actual incident outcome and additional care the patient may need as a result of it. Harm scores are rated on a scale of 1-4, where 1 represents the most significant harm and 4 indicates minor or no harm.

Note, however, that since our auditing team works to proactively identify errors before medications are dispatched, the actual harm risk is significantly minimised, even if the potential for harm is high. 

So, what does this all mean for you?

Through our rigorous clinical governance and auditing processes, we’re able to continuously improve our safety and quality standards to guarantee that each and every one of our patients has a positive experience with Juniper.

Our care model and ability to pre-empt and detect any potential practitioner errors is our greatest strength, and that's why we have such a stellar patient safety record.

We are committed to consistently raising the bar for the standard of digital healthcare in Australia — and these efforts show in our approach to clinical governance and auditing processes.