Quality And Clinica Governance Flashcards
What is clinical governance?
Term used to describe a systematic approach to maintaining and improving the quality of patient care within a health system
What are the dimensions of clinical governance
Person-centred
Safe
Effective
Efficient
Equitable
Timely
What is person-centred healthcare quality?
Partnership between pt, families and those delivering healthcare which respects individuals needs and values
- clear communication
- clear decision making
Safe in healthcare quality?
No avoidable injury or harm from healthcare
Appropriate clean and safe environment
Effective in HQ?
Does the intervention work
Most appropriate interventions, support and services for everyone
Efficient in HQ?
Output maximised for the given input cost?
Wasteful or harmful variation eradicated
Equitable in HQ?
All patients fairly treated
Distribution of care based on need?
High quality services to everyone, no matter who or where they live / from
Timely in HQ?
Appropriate treatment, support and services provided at right time
How many pts harmed in healthcare on avg?
1 in 10 pts harmed in healthcare
3-25% acute care
9% primary care
Factors that contribute to an adverse event?
Human factors
- teamwork, communication, stress, burnout
Structural factors
- reporting systems, workforce load, environment
Clinical factors
- complexity of care, length of stay
Components of clinical governance?
Education and training
Clinical audit
Clinical effectiveness
RnD
Openness
Risk management
How can HQ and the clinical gov process be delivered?
Setting quality standards
Delivering quality standards
Monitoring quality standards
Process of promoting implementation of research in clinical practice?
Critical appraisal of literature
Development of guidelines and protocols
Implementation strategies
Define clinical guideline
Systematically developed statements which assist in the decision making about appropriate healthcare for specific clinical conditions
Aims of clinical guidelines?
Provide tx recommendations
Develop standards for clinical audit
Education and training
Help pts make informed decisions
Improve communication between pt and professional
What are the evidence levels?
1 - systematic review and RCT
2 - cohort
3 - case-control
4 - case series
5 - lit review
Key clinical governance activities?
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
NHS education for Scotland, 3 ways of improving quality?
Clinical audit
Peer review
Enhanced significant event analysis
Research project
Quality improvement projects
Highly recommended topics for CPD on pt safety?
Medical emergencies - 2hrs / year
Disinfection and decon
Radiography and radiation protection
Legal / ethical issues
Complaints handling
Early detection oral cancer
Safeguarding
How can treatment quality be examined
SDRS
- dental reference officers
- pre / post treatment patient referrals
What is clinical audit?
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
Steps of clinical audit
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
What is the audit cycle?
- Identify problem or issue
- Set criteria for standards
- Observe practice /collect data
- Compare performance with criteria and standards
- Implement change
