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Dental Public Health > Quality Assurance > Flashcards

Quality Assurance Flashcards

1
Q

Name the five different views of what makes a good dentist?

A 
Dental view
Patient view
PCT (NHS commissioning view)
Dental Hospital View
Staff View
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2
Q

What is the dental view to what makes a good dentist?

A

Good clinical ability

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3
Q

What is the patient view of what makes a good dentist?

A

Pain free
seen on time
reasonble cost

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4
Q

What is the PCT view of what makes a good dentist?

A

Passes inspections
low/no complaints
FUlfil contractual obligations
Few emergencies

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5
Q

What is the dental hospital view of what makes a good dentist?

A

Appropriate referrals

Good quality referral letters

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6
Q

What is the staff view of what makes a good dentist?

A

Polite and considerate
Sees patients on time
personal development
Health and Safety

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7
Q

What are the 2 main ways of assessing the quality of healthcare?

A

Maxwells dimensions of quality

Donabedians Approach to evaluation of a system

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8
Q

What are maxwells 6 dimensions of quality? reference

A
  1. Access to services
  2. Relevance to need
  3. Social Acceptibilty
  4. Effectiveness
  5. Equity
  6. Efficiency and Economy
    Maxwell R 1984
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9
Q

What does access refer to according to maxwell?

A

Opening hour
location
any obvious barriers to service
can people get treatment when they need it

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10
Q

what does relevance refer to according to maxwell?

A

Is the balance of services the best that could be achieved when considering needs and wants of the whole population?

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11
Q

What does effectiveness refer to according to maxwell?

A

Is the treatment given evidence based an the best treatment available

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12
Q

What does the term equity refer according to maxwell?

A

are patients being fairly treated?

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13
Q

WHat does the term acceptability refer to according to maxwell?

A

How humanely and considerably is the treatment delivered, are confidentiality safeguarded?

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14
Q

What does the term efficiency refer to according to maxwell?

A

is the output maximised for the given input

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15
Q

Give an example where maxwells dimnsions of quality can be applied

A

Cleft lip and palate services in the UK

outcome of unilateral cleft lip and palate at aged 5 1998 showed:
40% poor dental arch relations and untreated caries
19% impossible to understand
Access to services was poor since services were centralised from 57 to 18 centres

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16
Q

What does Donabedian look at?

A

an approach to evaluation of a system

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17
Q

What three things are important to consider when evaluating an system?

A

structure: skills of the staff, the buildings and premises, and the equipment the organisation makes available
process: the methods that are adopted by the organisation to provide its services

outcome

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18
Q

What is usually used in Donabedians system instead of outcome and why?

A

output

because outcome is difficult to measure

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19
Q

Apply Donabedians system to cleft lip and palate?

A

structure: This considers the buildings, number of staff
Process: number of pateints treated and waiting times
Outcome: appearance, speech

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20
Q

What can be out in place for quality assurance?

A

A quality framework which is comprised of three stages:

Set standards
Local delivery
Monitoring

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21
Q

What kind of bodies set quality standards?

A

NICE

CQC

22
Q

What kind of bodies ensure quality is delivered locally?

A

Clinical Governance

23
Q

What kind of bodies and reports monitor quality?

A

CQC
Dental reference services
Vital signs report

24
Q

What is clinical governance?

A

Scally and Donaldson 1998

A framework through which

NHS organisations are accountable for continuously improving the quality of their services

and

safe-guarding the high standards of care

by creating an environment in which excellence in clinical care will flourish

25
Q

WHat 5 things are done to ensure clinical governance for GDP’s are being carried out?

A 
Clinical audit/peer review
CPD
Clinical Risk management
Complaints procedure
Addressing under performanece
26
Q

How often do clinical audits and peer reviews need to be performed?

A

15 hours every 3 years

27
Q

How much CPD need to be done?

A

75 hours verifiable
175 hours non verifiable
every 5 years

28
Q

What does clinical risk management consider?

A

compliance with statutory regulations, staff protection and critical event audit

29
Q

What features must a complaints procedure have?

A

an in house system

reasonable time frame

30
Q

What must be in place for addressing under performance?

A

whistle blowing policy

31
Q

Who is responsible for addressing under performance?

A

all members of the team

32
Q

According to Lord Darzi 2008 what are the domains of quality?

A

safety
effectivenss
patient experience

33
Q

What changes did Lord Darzi’s report on high qualiy care for all have on dental practices?

A

all practices were as a result are now monitored by CQC where as prevsiously private practices were exepmt

34
Q

WHat 7 bodies are responsible for quality of dentistry?

A 
PCT
GDC
Dental services division of BSA
CQC
National clinical assessment service
Colleagues and members of team
Yourselves
35
Q

What is the role of the PCT in ensuring quality?

A

They monitor contracts and assess performances

36
Q

WHat is the role of the GDC in ensuring quality?

A

fitness to practice
CPD
registatrion
private patient complaints

37
Q

What is the role of the BSA in ensuring quality?

A

monitor and advise on quality

38
Q

What is the role of nastional clinical assessment service ensuring quality?

A

support service, and concerns over the performance of a dentist

39
Q

What is the role of colleagues and team in ensuring quality?

A

ensure adhernence to regulation and raise concerns

40
Q

When was the CQC est?

A

April 2009

41
Q

WHat is the role of the CQC?

A

to act as an independant regulator of health and social care services

42
Q

What do the CQC perform annually?

A

health checks looking at

a. Quality of services :using performance indicators and compliance with core standards
b. financial management

43
Q

What do CQC produce at the end of their health checks?

A

special reports

44
Q

What do PCT’s use when assessing quality?

A

they use performance indicators

45
Q

What performance indicators are used by PCT’s?

A 
CQC reports
referrals to secondary care
PALS
Critical incidents
Whislt blowing
CLinical audit
random patient questionnaires given by DSD of BSA
46
Q

What is the purpose of the DSD of BSA?

A

ensures NHS treatment is necessary and carried out at a satisfactory level

47
Q

What do the DSD do?

A

they perform targeted practice inspections at the request of PCT in England but regular inspecions in Wales

48
Q

What report to DSD produce?

A

Vital signs report

49
Q

What us the purpose of vital signs repsort?

A

set of metrics monitoring key aspects of delivery of primary care dentistry

50
Q

What are the 7 indicators of quality used in the vital signs report?

A 
percentage of those:
re-attending in 3 months
urgent treatment
free repair/replacement
continuations
satisfied with treatment recieved
satisfied with time to wait for treatment
51
Q

How can the donabedian approach and maxwells dimensions of care be combined?

A

They can be combined to form the wright marrix

Dental Public Health (13 decks)

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