Quality And Clinica Governance

Question 1

What is clinical governance?

Answer 1

Term used to describe a systematic approach to maintaining and improving the quality of patient care within a health system

Question 2

What are the dimensions of clinical governance

Answer 2

Person-centred

Safe

Effective

Efficient

Equitable

Timely

Question 3

What is person-centred healthcare quality?

Answer 3

Partnership between pt, families and those delivering healthcare which respects individuals needs and values

• clear communication
• clear decision making

Question 4

Safe in healthcare quality?

Answer 4

No avoidable injury or harm from healthcare

Appropriate clean and safe environment

Question 5

Effective in HQ?

Answer 5

Does the intervention work

Most appropriate interventions, support and services for everyone

Question 6

Efficient in HQ?

Answer 6

Output maximised for the given input cost?

Wasteful or harmful variation eradicated

Question 7

Equitable in HQ?

Answer 7

All patients fairly treated

Distribution of care based on need?

High quality services to everyone, no matter who or where they live / from

Question 8

Timely in HQ?

Answer 8

Appropriate treatment, support and services provided at right time

Question 9

How many pts harmed in healthcare on avg?

Answer 9

1 in 10 pts harmed in healthcare

3-25% acute care

9% primary care

Question 10

Factors that contribute to an adverse event?

Answer 10

Human factors
- teamwork, communication, stress, burnout

Structural factors
- reporting systems, workforce load, environment

Clinical factors
- complexity of care, length of stay

Question 11

Components of clinical governance?

Answer 11

Education and training

Clinical audit

Clinical effectiveness

RnD

Openness

Risk management

Question 12

How can HQ and the clinical gov process be delivered?

Answer 12

Setting quality standards

Delivering quality standards

Monitoring quality standards

Question 13

Process of promoting implementation of research in clinical practice?

Answer 13

Critical appraisal of literature

Development of guidelines and protocols

Implementation strategies

Question 14

Define clinical guideline

Answer 14

Systematically developed statements which assist in the decision making about appropriate healthcare for specific clinical conditions

Question 15

Aims of clinical guidelines?

Answer 15

Provide tx recommendations

Develop standards for clinical audit

Education and training

Help pts make informed decisions

Improve communication between pt and professional

Question 16

What are the evidence levels?

Answer 16

1 - systematic review and RCT

2 - cohort

3 - case-control

4 - case series

5 - lit review

Question 17

Key clinical governance activities?

Answer 17

CPD for all staff

Clinical effectiveness, and evidence based practice in daily use

Openness on poor performance ad practice
- open to public scrutiny

Risk management
- pts and practitioners

Question 18

NHS education for Scotland, 3 ways of improving quality?

Answer 18

Clinical audit

Peer review

Enhanced significant event analysis

Research project

Quality improvement projects

Question 19

Highly recommended topics for CPD on pt safety?

Answer 19

Medical emergencies - 2hrs / year

Disinfection and decon

Radiography and radiation protection

Legal / ethical issues

Complaints handling

Early detection oral cancer

Safeguarding

Question 20

How can treatment quality be examined

Answer 20

SDRS

• dental reference officers
• pre / post treatment patient referrals

Question 21

What is clinical audit?

Answer 21

Process defined as

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

Key component is that performance is reviewed

Question 22

Steps of clinical audit

Answer 22

Select topic

Set agreed standards and data requirements

Observe practice and collect data

Analyse data and determine deviation

Identify areas of change needed

Make changes

Repeat audit process

Question 23

What is the audit cycle?

Answer 23

1. Identify problem or issue
2. Set criteria for standards
3. Observe practice /collect data
4. Compare performance with criteria and standards
5. Implement change