Clinical Governance Flashcards
What is clinical governance?
a systematic approach to maintaining and improving the quality of patient care within a health system
a framework through which NHS 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 clinical care will flourish
What are the 6 dimensions of healthcare quality?
- person-centred
- safe
- effective
- efficient
- equitable
- timely
What does it mean for healthcare to be person-centred?
partnership between patient, families and those delivering healthcare which respects individual needs and values and demonstrates compassion, continuity, clear communication and shared decision making
What does it mean for healthcare to be safe?
- no avoidable injury or harm from healthcare received
- appropriate, clean and safe environment provided for delivery of healthcare services
What does it mean for healthcare to be effective?
- ascertaining that intervention works
- determining the most appropriate interventions, support and services provided to everyone
- determining whether the benefit is maximised for the given costs
- wasteful or harmful variation eradicated
What does it mean for healthcare to be equitable?
- ensuring all patients are treated fairly
- ensuring distribution of care is based on needs
- high quality services provided to everyone
What does it mean for healthcare to be timely?
Appropriate treatment, support and services provided at the right rime for everyone
What factors contribute to adverse events?
- human factors
- teamwork
- communication
- stress
- burnout
- structural factors
- reporting systems
- infrastructure
- workforce loads
- environment
- clinical factors
- complexity of care
- length of stay
What are the 6 components of Clinical Governance?
- education & training
- clinical audit
- clinical effectiveness
- research & development
- openness
- risk management
How can the dimensions of healthcare quality and clinical governance process be delivered?
- setting quality standards
- delivering quality standards
- monitoring quality standards
How can quality standards be set?
- good clinical practice changes in light of evidence from research
- reduction to minimum time lag of implementation of research findings into clinical practice
- promoting implementation of research in clinical practice
- critical appraisal of literature
- development of clinical guidelines/protocols
- implementation strategies
- clinical guideline definition
What are the 7 As of leaks between research and practice?
- aware
- accept
- applicable
- able
- act
- agree
- adhere
What is the aim of clinical guidelines?
- improve the quality of healthcare
- recommendations
- standards for clinical audit
- education and training
- informed patient decisions
- improve communication
What clinical guidance currently exists for dentistry?
- SIGN Guidelines
- NICE
- SDCEP
- HIS
What are the different evidence levels and which study types fit into each?
- 1
- systematic review
- Cochrane
- RCT
- systematic review
- 2
- cohort
- 3
- case-control
- 4
- case series
- 5
- narrative review
- editorial
- N/A
- case report
- epidemiology
- animal studies
What are the strongest sources of scientific evidence?
- meta-analyses
- systematic reviews
What is the aim of SDCEP?
to support dental teams throughout Scotland by providing guidance developed by the profession for the profession on topics identified as priorities for dentistry in Scotland
How can quality standards be delivered?
- life long learning
- CPD
- 100 hours every 5 years
- CPD
What are the different formats of CPD?
- courses and lectures
- training days
- peer review
- clinical audit
- reading journals
- attending conferences
- e-learning activity
What are the highly recommended topics for CPD?
- medical emergencies
- disinfection and decontamination
- radiography and radiation protection
- legal and ethical issues
- complaints handling
- oral cancer: early detection
- safeguarding children/young people/adults
What is SDRS and what does it do?
- Scottish Dental Reference Service
- monitor quality and probity of treatment
- review sample of patients yearly
What is a clinical audit?
a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change
What are the 7 steps of a clinical audit?
- select topic
- set agreed standards & decide on data
- observe practice and collect data
- analyse data and determine deviations
- identify any areas of change required
- make necessary changes
- repeat audit process and determine improvements
What are the educational strengths of audit?
- critical review of current practice
- encourages learning new things
- small group work
- modifying attitudes
- management of clinical conditions
- re-enforcemeny of agreed procedures
- observation of practice
- indicate gaps in knowledge/skills
What is the aim of a peer review?
to share experiences and identify area in which changes can be made with the objective of improving the quality of care/service offered to patients, share learning and implement change
