PH3 - Quality in healthcare and clinical governance

Question 1

Define clinical governance.

Answer 1

Systematic approach to maintaining and improving the quality of patient care within a health system

Question 2

What are the dimensions of healthcare quality?

Answer 2

Defined by institute of medicine:
- person-centred
- safe
- effective
- efficient
- equitable
- timely

Question 3

What is meant by person-centred healthcare?

Answer 3

• partnership between patients, families and those delivering healthcare
• wider than patient centred

Question 4

What is meant by safe healthcare?

Answer 4

• no avoidable injury or harm from healthcare received
• appropriate, clean and safe environment

Question 5

What is meant by effective healthcare?

Answer 5

• does the intervention work?
• most appropriate interventions, support and services provided

Question 6

What is meant by efficient healthcare?

Answer 6

• is output/benefit maximised for given input
• wasteful/harmful variation eradicated

Question 7

What is meant by equitable healthcare?

Answer 7

• patients fairly treated
• distribution of care based on need (not just on who demands it)
• high quality service provided to everyone

Question 8

What is meant by timely healthcare?

Answer 8

Appropriate treatment, support and services provided at correct time for everyone

Question 9

What factors contribute to adverse events?

Answer 9

• human factors (teamwork, communication)
• structural factors (infrastructure, workload, environment)
• clinical factors (complexity of case)

Question 10

What are the components of clinical governance?

Answer 10

• education and training
• clinical audit
• clinical effectiveness
• research and development
• openness
• risk management

Question 11

What are the aims of clinical guidance?

Answer 11

• provide recommendations for treatment
• develop standards for audits
• used in education
• help patients make informed decisions
• improve communication with patients

Question 12

What guidelines are used in dentistry in Scotland?

Answer 12

• SIGN
• NICE
• SDCEP
• Healthcare improvement Scotland

Question 13

What format can CPD take?

Answer 13

• courses/lectures
• training days
• peer review
• clinical audit
• reading journals
• attending conferences
• E-learning

Question 14

What is the SDRS?

Answer 14

• 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

Question 15

What is a clinical audit?

Answer 15

Quality improvement that has been defined as patient care and outcomes through systematic review of care against explicit criteria and the implementation of change

Question 16

What is the audit cycle?

Answer 16

1. identify problem or issue
2. set criteria and standards
3. observe practice (live) or data collection (retrospective)
4. compare performance with criteria and standards
5. implement change

Question 17

What is the aim of peer review?

Answer 17

• share experiences and identify areas which can be changed to improve quality of care
• share learning and implement change