Operations Flashcards
How do you ensure ‘informed consent’ is given?
Consent policy, based on Department of Health’s model consent policy
Clients have to sign a consent form prior to their first appointment. T&Cs and permission to contact GP.
Following first appointment - Care plan is devised collaboratively, capacity assessed by clinician.
Consent discussions and decisions are documented in client notes. Clients can withdraw at any point.
What type of consent do you collect and when?
General Consent - for service delivery, at first appointment and then ongoing as part of care plan.
Marketing - at first appointment
Sharing information with third parties (e.g. GP) - at first appointment
Photography or video recording - if applicable (e.g. ADOS)
Data processing - e.g. records request, deletion of records etc.
How do you manage consent for age 14 and above?
Young people aged 14 or over are presumed to have the capacity to consent to medical treatment (if they are deemed to understand the nature and implications of the proposed treatment).
Assessment of capacity done by clinicians at first appointment.
Capacity documented in client notes.
What can affect consent?
Mental capacity of client / cognitive impairments.
Age and maturity
Cultural and religious beliefs
Language barriers
Fear and anxiety
Substance abuse
Communication skills (of service / clinician)
Power dynamics
Time constraints, urgency of the situation
Complexity of the treatment
What type of emergencies could you face with your service?
Medical Emergencies: cardiac arrest, stroke, severe allergic reactions, seizures, diabetic emergencies etc
Mental Health Crises: suicide attempts, severe self-harm, panic attacks, psychosis, aggression or violence
Other non health related emergencies (e.g fire, flood, bomb threat etc)
How do you manage medical emergencies?
Medical emergencies: Immediate assessment, call 999, provide first aid if trained, contact emergency contacts, document incident.
Mental health crises: Follow established crisis management protocols, involve appropriate staff, consider involuntary detention if necessary, document incidents.
Environmental emergencies: Follow evacuation procedures, communicate with staff and clients, assess damage, and implement recovery plan.
Late Hours/Out of Hours: What safety plans do you have in place?
Out of hours voicemail is set on all clinic phone lines, explaining opening hours and directing clients to emergency services, support lines and offering for the client to leave a message that will be responded to on the next working day.
Practice manager and registered manager numbers provided for any out of hour staff/clinic needs
Lone working policy, risk assessments and staff check in/out with duty clinician for any lone working needs.
How do you manage lone working?
Lone Working Policy
Risk assessments
Check in/out with staff
Contact numbers provided
How do patients make a choice for service, time, location & cost?
NO RESPONSE - AWAITING INPUT FROM FIONA
How do you manage patients with special needs or assistance requirements?
Undertook accessibility audit
Ramp available for clients who need wheelchair access
Translation services/sign language interpreters provided through clearvoice
Hearing Loop
Staff member on reception at all times to provide assistance
Required training on disability and accessibility needs required from all staff when joining the service
Video appointments offered
Fire Marshals on site to support with evacuations
How do you engage patients with your service and feedback?
Feedback from sent at discharge
Expert by experience sent in all discharge letters
Feedback (positive or negative) reviewed at weekly management meeting formally at quarterly Clinical Governance Meeting (closing the loop)
Feedback to google reviews linked on all reception team emails
Client feedback form QR code in reception area
Clients verbally encouraged to report feedback from staff where appropriate
Verbal and informal feedback recorded
What are your main risks with medications/prescribing?
Errors on prescription (eg. wrong dose, unclear dose, wrong strength, wrong time or not specifying time, wrong medication, wrong quantity / amount of days).
Wrong medication to wrong patient/client, or wrong pharmacy.
Polypharmacy / checking for interactions
Allergies
Not checking with the patient do they understand what they are being prescribed.
Physical health checks (weight, height, age, BP, pulse etc).
Unsigned and undated prescriptions.
How do you mitigate prescription risks?
Strong safety culture
Clear policy on medicines management
Electronic prescribing systems
Clear handwritting for handwritten prescriptions
Generic drug name (not brand)
No abbreviations
Review all prescriptions - prescribing checklist
Review that the dosage and frequency matches what the patient understands their prescription to be.
Making sure that it’s been prescribed in the correct form and via the correct route.
All prescribers have access to patient information including other medications being taken and any allergies. Checking for drug interactions before prescribing a new medication.
Making sure all prescriptions are dated and signed.
Staff training for prescription writing and best practice.
Review practice of prescriptions before handing over
Prescribing checklist to mitigate errors
If you store medication on site, how do you keep them safe?
No medications stored on site
Prescription pads in a locked safe
How do people raise a Health & Safety concern?
Report to practice manager and/or operations director
Online accident / incident form
Reviewed at weekly management meeting
Open communication culture
