Ethics Poor Performance Flashcards
What is poor performance?
Any aspect of performance which:
- poses a threat or potential threat to patient safety
- expose services to financial or other substantial risk
- undermine the reputation or efficiency of services in some significant way
- are outside acceptable practice guidelines and standards
Why might dentists have poor performance?
Rising patient expectations Ill health Bereavement/divorce/relationships Working in toxic environments Not keeping up to date Difficult and challenging behaviours Working in isolation Resource limitations Working beyond competence
Pressures on dentists
Decontamination Home -balance CQC (independent regulator of health services in the UK) Patient expectations Information governance CPD Clinical governance Staff Contracts Business vs healthcare
Pressures on dental students
Decontamination Information governance Clinical governance Home - balance Patient expectations Staff v student relationships Relationships Illness Finances Exams Learning in new clinical skills
Some problems causing poor performance
Lack of knowledge or skill Ill health, especially mental health Substance abuse Personality disorder Lack of probity or professional values Lack of support A combo of factors
Clinical concerns
Clinical decision making/diagnosis
Consultation skills
Technical skills
Record keeping
Clinical knowledge and skills
Induction appropriate or sufficient or non-existent
Difficult understanding the limits of their competence
Professional development - education, CPD, training
Confidentially and consent
Making appropriate referrals
Typical behavioural concerns
Poor communication with colleagues Inability to manage stress Poor influencing/managing upwards Conflict avoidance/mishandling Lack of ‘corporate’ engagement Interpersonal legacies Chronic embitterment
Behavioural indicators for mental health problems
Absence Change in behaviour Poor time management Inability to prioritise Inappropriate behaviour Complaints Withdrawal Multiple factors
Signs dentists are under pressure
Poor clinical performance Sickness and absence higher than usual Rigidity Rage The disappearing act Defensiveness and denial Refusal to cover for other staff Culture of silence
Partners in performance
Patient safety issues: GDC
Local support: PASS, AT
National support: NCAS, BSA, defence organisations
Alcohol/drugs/mental health: Dentist Health Support Scheme
Probity: counter fraud
Education: HEE deanery, royal colleges
Criminal activities: police
