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ESA4 > 1 - HaDSoc - Quality, Safety + Evidence-based Medicine + Inequalities in Healthcare > Flashcards

1 - HaDSoc - Quality, Safety + Evidence-based Medicine + Inequalities in Healthcare Flashcards

1
Q

List some causes of human errors which jeopardise patient safety:

A
  • Incompetence
  • Negligence
  • Carelessness
  • Poor motivation
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2
Q

List some causes of system errors which jeopardise patient safety:

A
  • Inadequate training
  • Long hours
  • Similar looking bottles for different things
  • Lack of checklists
  • Lack of standardisation
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3
Q

Describe James Reason’s framework of error:

A

‘Swiss-cheese’ model:

When multiple active/latent failures occur, they may line up allowing a potential hazard to fall through the layers of defenses, barriers and safeguards, causing harm.

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4
Q

List some ways we can reduce human/system errors to improve patient safety:

A
  • Avoid reliance on memory
  • Make things visible
  • Simplify processes
  • Standardise common processes
  • Use checklists routinely
  • Decrease reliance on vigilance
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5
Q

What mechanisms are in place in NHS organisations to achieve clinical governance?

A
  • Standard setting ie NICE guidelines
  • Commissioning - local services based on local needs
  • Financial incentives - to meet quality standards and patient goals efficiently
  • Disclosure of accounts
  • Regulation via CQC
  • Data gathering and feedback
  • Clinical audits
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6
Q

Describe a clinical audit:

A
  • Choose a topic
  • Set standards due to research evidence
  • Evaluate current practice
  • Implement standards
  • Evaluate new practice
  • Change practice if not ideal
  • Re-audit to ensure improvement
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7
Q

What is evidence-based practise?

A

The integration of individual clinical expertise with the best clinical evidence from systematic research, to evaluate the effectiveness and cost-effectiveness of a drug/practice/intervention etc.

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8
Q

What factors prevent the use of evidence-based medicine?

A
  • Professional opinion
  • Clinical fashions
  • Historical practice
  • Social culture
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9
Q

What are the criticisms of using systematic reviews of RCTs to inform evidence-based practise?

A
  • Impossible to maintain up-to-date systematic reviews across all specialities
  • RCTs are not suitable for everything (not feasible/necessary/ethical)
  • RCTs are often funded by multinational pharmaceutical companies - may be unethical/biased
  • RCT informs of the benefit of an intervention ON AVERAGE, not best for every individual - problem if clinician follows guidelines as rules
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10
Q

What are some difficulties faced when trying to implement new evidence-based medicine into practice:

A
  • Information may not be widely distributed due to cost
  • Doctor’s reject new information, rely on habits and professional judgement
  • Organisation in healthcare doesn’t support new evidence
  • Patients may not wish to follow evidence
  • Financial constraints
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11
Q

What name is given to the collection of numerical data?

A

Quantitative research

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12
Q

List some types of obtaining quantitative research:

A
  • Questionnaires
  • Census
  • RCTs
  • Cohort studies
  • Case-control studies
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13
Q

What are the strengths of quantitative research?

A
  • Allows comparisons
  • Good at describing + measuring
  • Good at finding relationships between things
  • Reliable
  • Repeatable
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14
Q

What are the weaknesses of quantitative research?

A
  • May force people into inappropriate categories
  • Do not allow people to express themselves properly
  • May not access all available information
  • May be not effective in establishing causality
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15
Q

What name describes exploratory data collection to understand underlying reasons, opinions and motivations?

A

Qualitative methods

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16
Q

List some types of obtaining qualitative data:

A
  • Observation in natural context (ethnography)
  • Interviews
  • Focus groups
  • Documented reasons/opinions ie patient diaries, medical records, media
17
Q

What are the strengths of qualitative data?

A
  • Can see perspective of someone in the situation
  • Reveals much more information than quantitative methods
  • Explains relationships between variables
18
Q

What are the weaknesses of qualitative data?

A
  • Doesn’t find consistent relationships between variables
  • Small samples so doesn’t not allow generalisation
  • Very labour intensive
19
Q

What type of data collection method would you use to find out how many cigarettes people smoke on average per week?

A

Quantitative methods ie survey

20
Q

What type of data collection method would you use to find out why people don’t give up smoking?

A

Qualitative methods ie interview

21
Q

Define inequality:

A

When things are different and not equal

22
Q

Define inequity:

A

Inequalities that are unfair and avoidable

23
Q

The index of multiple deprivation per geographical area is based on which 7 factors?

A

1) Income
2) Crime
3) Health + Disability
4) Employment
5) Education
6) Barriers to housing
7) Services

24
Q

What is the artefact theory of why health inequalities between social classes exist:

A

The differences are due to the way in which the statistics were collected

25
Q

What is the social selection theory of why health inequalities between social classes exist:

A

Your social position is caused by your health status. Therefore if you have poor health, you will be live in an area of deprivation.

26
Q

What is the behavioural-cultural theory of why health inequalities between social classes exist?

A

Peoples social status determines the type of health-related behaviours they engage in. The most disadvantaged engage in the most risky behaviours.

27
Q

What is the materialist theory of why health inequalities between social classes exist?

A

Access to healthcare declines as you move down the social hierarchy.

28
Q

What is the psychosocial theory of why health inequalities between social classes exist?

A

Buffers for stress are socially distributed: the most disadvantaged have least ability to cope with stress, which affects health directly and indirectly

29
Q

What is the income distribution theory of why health inequalities between social classes exist?

A

Countries with the greatest income inequalities have greater health inequalities. Income inequality causes threat, resulting in stress and poor health.

30
Q

More deprived people are more likely to use GP + A&E services than preventative + specialist services. What are the possible explanations for this?

A
  • Social norm in more deprived areas to only go to the doctor when something is really wrong (therefore would not use preventative measures ie screening)
  • Difficulty in signposting resources into the more deprived areas
  • Lack of cultural alignment between the lower socio-economic class needs and health services provided

ESA4 (36 decks)

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