While there are multiple definitions and models for Clinical Governance, we believe it is well defined as: ‘The framework through which organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in healthcare will flourish’.
Offshore work sites are a special type of remote site. In addition to the logistics of transporting a critical medical case to and from the platforms and vessels, onward movement requires special consideration. This includes consideration around transportation from the site to the shore, onward movement to a stabilising health facility, followed by access to definitive care within a health centre or hospital. All these aspects need to be considered when designing a medical evacuation response plan with effective case management built in.
Offshore medical professionals are required to practice good medicine while working offshore as they provide emergency and primary healthcare to their patients. Despite the logistics challenges, the process must be synchronised with the response actions of all stakeholders involved, including offshore managers, rescue teams, medical evacuations professionals and ground assistance providers.
In the context of remote sites, the practice of offshore medicine requires close and efficient governance. This is to ensure compliance with operating procedures and quality delivery, to overcome the challenges associated with healthcare delivery to offshore operations. Clinical governance is an essential component of high-quality medical services and, though not restricted to the offshore clinical setting, is essential in offshore medical practice.
Topside Support, as a term for the offshore medical services industry, is the provision of medical advisory through, predominantly, a physician-led medical team to offshore medical professionals. A Topside Support provider discusses case management, formulates a treatment plan, and considers potential patient movement to access definitive care. In many instances, Topside Support communication can be enhanced by the utilisation of audio/video technology and telemedicine.
Topside Support plays a vital role in ensuring the quality of offshore medical practice. It is considered the first line in the implementation of a successful and efficient medical governance structure. Factors include the provision of medical recommendations around clinical case management, directing offshore medical professionals to international best practice, and ensuring compliance to standard operating procedures.
Through many years of working with the offshore and maritime industries, International SOS has refined the model and delivery of Topside Support services to the offshore industry. While managing occupational work-related cases onsite, new, and sophisticated concepts of Topside Support not only provide pure medical advisory, but also consider industry standards (e.g., OSHA) and protocols linked to case management, address return to work fitness and ensure end-to-end case management towards maximum medical recovery or improvement.
International SOS’s model of offshore service delivery, ensuring alignment with the Injury and Illness Case Management Framework, has become the industry standard. A significant proportion of clinical governance is planned and managed through our worldwide network of Response Centres: International SOS owned and operated facilities that are strategically located to deliver Topside Support.
Medical services platforms generate policies and protocols that set the relationship between the site medical professionals and the Topside Support team. This includes describing the list of clinical indications requiring case escalation to a Response Centre, explaining in detail the procedure of escalation and details required to open a clinical case within the system, directing discussions around clinical pathways and subsequent recommendations, and allocating roles and responsibilities around case reporting between the offshore and the Topside Support team. This constitutes the first layer of governance.
Then comes the requirement for a Topside Support provider to document the case details received and the associated medical advice provided within the Response Centre, using a Topside Support specialised Electronic Medical Records (EMR) system. The EMR allows healthcare documentation, archiving and subsequent data extraction, data analytics and case reporting. This is a standard capability within International SOS Response Centres and is an integral component of medical governance for global offshore clinical operations support. Access to recorded Topside Support engagements and escalation enables future training, service gap analysis and documentations of lessons learned.
Another aspect of the governance structure, associated with Topside Support delivery, is the standardisation of service delivery. This includes setting the model for service delivery and applying control measures for healthcare on-site and ensuring quality management systems application. The latter provides the standard process through which quality driven programmes such as audits and improvement initiatives can be benchmarked across medical services platforms globally for worldwide contracts.
Furthermore, Topside Support provides the capability to understand healthcare issues and challenges within the context of offshore operations. Beyond providing a holistic view of medical planning and support to a fleet of offshore clinics, the raw data collected and analysed, can provide meaningful insights. It might detect a disease outbreak, or a consistent health problem at a work site due to a gap in a specific process. This enables the team to raise the alarm early and put corrective methods in place. Through data reporting, organisations can also build an evidence-based understanding of many lagging and leading indicators of the health and wellbeing of their offshore workforce to better understand their health trends.
How we can Support you
With more than 35 years' experience providing Topside services to the offshore Oil & Gas industries, we have developed a strong understanding of your working environment and medical needs. Please get in touch with us by completing the below form and we will contact you as soon as possible.