PH3 - Quality in healthcare and clinical governance Flashcards
Define clinical governance.
Systematic approach to maintaining and improving the quality of patient care within a health system
What are the dimensions of healthcare quality?
Defined by institute of medicine:
- person-centred
- safe
- effective
- efficient
- equitable
- timely
What is meant by person-centred healthcare?
- partnership between patients, families and those delivering healthcare
- wider than patient centred
What is meant by safe healthcare?
- no avoidable injury or harm from healthcare received
- appropriate, clean and safe environment
What is meant by effective healthcare?
- does the intervention work?
- most appropriate interventions, support and services provided
What is meant by efficient healthcare?
- is output/benefit maximised for given input
- wasteful/harmful variation eradicated
What is meant by equitable healthcare?
- patients fairly treated
- distribution of care based on need (not just on who demands it)
- high quality service provided to everyone
What is meant by timely healthcare?
Appropriate treatment, support and services provided at correct time for everyone
What factors contribute to adverse events?
- human factors (teamwork, communication)
- structural factors (infrastructure, workload, environment)
- clinical factors (complexity of case)
What are the components of clinical governance?
- education and training
- clinical audit
- clinical effectiveness
- research and development
- openness
- risk management
What are the aims of clinical guidance?
- provide recommendations for treatment
- develop standards for audits
- used in education
- help patients make informed decisions
- improve communication with patients
What guidelines are used in dentistry in Scotland?
- SIGN
- NICE
- SDCEP
- Healthcare improvement Scotland
What format can CPD take?
- courses/lectures
- training days
- peer review
- clinical audit
- reading journals
- attending conferences
- E-learning
What is the SDRS?
- Scottish dental reference service
- used for expensive NHS treatment requiring prior approval
- select random patients to review to ensure quality of treatment and correct claims
What is a clinical audit?
Quality improvement that has been defined as patient care and outcomes through systematic review of care against explicit criteria and the implementation of change
What is the audit cycle?
- identify problem or issue
- set criteria and standards
- observe practice (live) or data collection (retrospective)
- compare performance with criteria and standards
- implement change
What is the aim of peer review?
- share experiences and identify areas which can be changed to improve quality of care
- share learning and implement change
