Clinical Governance Flashcards
What is clinical governance?
A systematic approach to maintaining and improving the quality of patient care within a health system
What are the dimensions of healthcare equality?
- person-centred
- safe
- effective
- efficient
- equitable
- timely
What is meant by patient-centred healthcare quality?
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 is meant by safe healthcare quality?
- no avoidable injury or harm from healthcare received
- appropriate, clean and safe environment provided for delivery of healthcare services
What is meant by effective healthcare quality?
- does the intervention work?
- the most appropriate interventions, support and services provided to everyone
What is meant by efficient healthcare quality?
- is the output (benefit) maximised for the given input (costs)?
- wasteful or harmful variation eradicated
What is meant by equitable healthcare quality?
- are all patients fairly treated?
- is the distribution of care based on need?
- high quality services provided to everyone, no matter who they are or where they live
What is meant by timely healthcare quality?
appropriate treatment, support and services provided at the right time for everyone
What factors can contribute to adverse healthcare events occuring?
- human factors such as teamwork, communication, stress and burnout
- structural factors such as reporting systems, infrastructure, workforce loads and the environment
- clinical factors such as complexity of care & length of stay
What are the different components that make up clinical governance?
- education & training
- clinical audit
- clinical effectiveness
- research & development
- openness
- risk management
What can help ensure that the dimensions of healthcare quality & the clinical governance process are delivered?
- setting quality standards
- delivering quality standards
- monitoring quality standards
What is meant by “setting good quality standards” ?
systematically developed statements which assist in the decision-making about appropriate healthcare for specific clinical conditions
What is the aim of clinical guidelines?
Aim to improve the quality of healthcare provided
What are the uses of clinical guidelines?
- provide recommendations for the treatment & care of individuals
- used to develop standards for clinical audit
- used in education & training of health professionals
- help patients to make informed decisions
- improve communication between patient & health professionals
Give examples of clinical guidelines used in Scottish dentistry:
- SIGN guidelines
- NICE
- SDCEP
- Healthcare Improvement Scotland
What study type is considered evidence level 1?
Systematic review (cochrane) & RCT
What study type is considered evidence level 2?
Cohort
What study type is considered evidence level 3?
Case-control
What study type is considered evidence level 4?
Case series
What study type is considered evidence level 5?
Narrative Review, editorial
What is considered the strongest type of scientific evidence?
Meta-analysis & systematic reviews
What is considered the weakest type of scientific evidence?
Case reports, opinion papers & letters
Give examples of some key clinical governance activities that are carried out to ensure quality standards are maintained in healthcare?
- education & training/CPD of all staff
- risk management
- openness of poor performance & practise
What is CPD? How does it apply to dentistry?
Continuing Personal Development
- “the ethical duty of dentists to continue to undertake appropriate continuing education for the duration of their professional practise” (GDC)
What is involved in CPD?
Provides NHS staff the opportunity to continuously update their skills & knowledge
- eg taking part in educational courses
What are the CPD requirements for dentists as set out by the GDC?
100 hours verifiable CPD within 5 year cycle & at least 10 hours verifiable across 2 consecutive years (from 2017 onwards)
What is the format of CPD for dentists?
- courses and lectures
- training days
- peer review
- clinical audit
- reading journals
- attending conferences
- E-learning activity
What are some CPD topics that are highly recommended by the GDC?
- medical emergencies
- disinfection & decontamination
- radiography & radiation protection
- legal and ethical issues
- complaints handling
- oral cancer: early detection
- safeguarding children and young people
What is the function of the Scottish Dental Reference Service (SDRS)?
To monitor quality and probity of dental treatment by reviewing a sample of patients each year
What is the definition of 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
- ensures what should be being done is being done
What are the steps involved in a clinical audit ?
- select topic
- set agreed standards & decide on data requirements
- observe practise & collect data
- analyse data & determine any deviation from standard
- identify any areas of change required
- make necessary changes
- repeat audit process
Discuss the 5 parts of the audit cycle:
- identify problem or issue
- set criteria & standards
- observe practise / data collection
- compare performance with criteria & standards
- implement change
