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MPharm Stage 1 > Unit 4 Quality > Flashcards

Unit 4 Quality Flashcards

1
Q

What are the WHO six dimensions of quality that healthcare systems must consider?

A

Require healthcare to be:

  • Effective: Providing services based on evidence and which produce a clear benefit
  • Efficient: Avoiding waste
  • Timely: Reducing waits and sometimes harmful delays
  • Acceptable/patient-centred: Establishing a partnership between healthcare
    professionals and patients to ensure care respects patient needs and preferences
  • Equitable: Providing care that does not vary in quality because of a service users’
    characteristics
  • Safe: Avoiding harm from care that is intended to help people
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2
Q

Clinical governance definition

A

a framework for which healthcare organisations are accountable for continuously improving their quality of services and safeguarding high quality of care.

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3
Q

Quality assurance

A

the process of checking that service standards are met and encouraging continuous improvement - it is essential in order to minimise harm and maximise benefits.

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4
Q

Quality improvement

A

Can help services meet the six dimensions of quality.
QI culture is central to governance and performance management.
Monitoring components of high quality service helps providers to develop a greater understanding of necessary improvements to provide the highest quality service

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5
Q

Tools that can be used for quality monitoring

A

Audit
Self assessment
Patient satisfaction surveys

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6
Q

Audit

A

a way to find out if services are being provided in line with standards and also helps to reduce the risk of errors. Audit should identify errors quickly and manage them effectively.

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7
Q

NHSE is responsible for providing national direction on…

A
  • Service improvement and transformation
  • Governance and accountability
  • Standards of best practice
  • Quality of data and information
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8
Q

Where does NHSE receive funding from?

A

Department of
Health and Social Care.

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9
Q

Integrated care systems

A

Where local partners work together creating better services based on local need
Aim to improve healthcare services by focussing on reducing health inequalities

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10
Q

Integrated care partnerships

A

Committee brought together by Local Authorities and NHS, comprised of a broad alliance of organisations and other representatives as equal partners concerned with improving health and social care services to ensure patients receive comprehensive care they need.

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11
Q

Integrated care boards

A

Statuatory NHS organisation responsible for meeting health needs for population, managing NHS budget and arranging for provision of health services in a geographical area.

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12
Q

Primary Care Networks

A

Many GP practices, pharmacies, hospitals working together covering 30-50k patients.
Bigger teams of staff, stay open for longer.

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13
Q

What are community pharmacies contracted and commissioned under?

A

Community Pharmacy Contractual Framework (CPCF)
CPCF is negotiated nationally (rather than locally) between NHSE, the Department of Health and Social Care and Community Pharmacy England (CPE);
the CPE is the pharmacy sector’s representative for the purposes of this
negotiation.

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14
Q

How does Clinical governance impact day to day roles and responsibilities of a pharmacist

A

Ensures pharmacist provides safe, effective and high quality care to patients.

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15
Q

What benefits would good Clinical governance provide to an organisation?

A

Helps maintain high standards of care, improves patient safety, enhances staff training and boosts overall quailty of services.

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16
Q

7 key components within clinical governance

A
  1. Risk management
  2. Clinical audit (review and improve practice)
  3. Premises standards
  4. Clinical effectiveness
  5. Patient and public involvement
  6. Information and communication
  7. Staffing and staff management
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17
Q

Community Pharmacy Contractual Framework (CPCF) role

A

Sets out the terms and conditions for operating a Community
Pharmacy, offering NHS services in England and Wales; the
arrangements are different in Scotland.

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18
Q

Clinical audit

A

Systematically looking at procedures used for diagnosis, care and treatment, examining how associated resources are used and investigating the effect care has on outcomes and quality of life for the patient

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19
Q

What three aspects of service provision can clinical audit look at?

A

Structure: people, equipment, consumables, space & training available to provide a
service
* Process: systems and procedures in place, which can include prescribing policies and disease management guidelines
* Outcomes: results of activity, especially patient health but including satisfaction

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20
Q

Why are clinical audits completed

A
  • To make sure we are doing the right things in the right way
  • To improve the quality of care for the patient
  • To reduce costs for the NHS
  • To ensure public money is used cost-effectively
  • Because the future of pharmacy depends on drug use and service provision that is proven to be safe, effective and efficient
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21
Q

Cycle for clinical audit

A

Identify topic
Set standard/guideline
Measure practice against standards
Identify areas to be changed
Implement change in practice
Re-audit to ensure change has been effective
EVIDENCE
repeat

22
Q

Since when has audit in community pharmacy been a requirement?

A

2005

23
Q

National clinical audit of 2022/23

A

focussing on the potential harm caused by taking valproate during pregnancy
community pharmacy teams were asked to identify female patients
of childbearing potential currently being prescribed valproate, and to offer them educational
materials as well as referring them to their GP practice for a specialist review and
consideration of appropriate contraception

24
Q

2 elements of the standards to which clinical audits work towards

A
  • Qualitative criteria – a statement of what should be done
  • Quantitative levels of performance – a percentage target for achievement
25
Q

3 questions to answer before testing an improvement concept

A

What are we trying to accomplish?
How will we know that a change is an improvement?
What change can we make that will result in improvement?

26
Q

PDSA cycle

A

Plan- change to be tested or implemented
Do- carry out test/change
Study-based on the measurable outcomes agreed before starting out, collect data before and after the change and reflect on the impact of the change and what was learned
Act- plan the next change cycle or full implementation.

27
Q

What incentives have been offered and by who?

A

quality payments have been introduced for community pharmacy through the
Pharmacy Quality Scheme (PQS)
Voluntary scheme supports delivery of the NHS Long
Term Plan and rewards community pharmacy contractors that achieve quality criteria in the
three domains of healthcare quality – clinical effectiveness, patient safety and patient
experience.

28
Q

Adverse Drug Reactions (ADRs)

A

Any response to a
drug which is noxious, unintended and occurs at doses used for prophylaxis, diagnosis or therapy

29
Q

Medication Error

A

Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of health professional, patient or consumer

30
Q

Latent errors

A

Hidden errors

31
Q

Active errors

A

Upfront errors

32
Q

6 standards RPS published that must be adhered to when there is an error

A

1) Be open and honest when things go wrong
2) Report patient safety incidents to the appropriate local or
national reporting programme
3) Investigate and learn from all incidents, including those
that cause harm and those that are “no harm” or “near-
miss”
4) Share what you have learnt to make local or national
systems of care safer
5) Take action to change practice or improve local or
national systems of care
6) Review changes to practice

33
Q

Near miss

A

An error that occurs which has the potential for harm but doesn’t actually reach the patient is termed ‘a near-miss’.

34
Q

For errors that reach patient, where are errors reported

A

NHS England

35
Q

Who seeks to collect and collate data on safety issues and who is this being replaced by?

A

National Reporting and Learning System (NRLS)
replaced by
Learn from patient safety events (LFPSE) service

36
Q

very common

A

> 1 in 10

37
Q

common

A

between 1 in 10 and 1 in 100

38
Q

uncommon

A

between 1 in 100 and 1 in 1000

39
Q

rare

A

between 1 in 1000 and 1 in 10000

40
Q

very rare

A

fewer than 1 in 10000

41
Q

Yellow card

A

reporting suspected adverse reactions to medications

42
Q

Black triangle drugs

A

drugs new to the market it is being monitored even more intensively than other medicines

43
Q

Black label drugs

A

medications that have been reviewed but didnt pass so can’t be given out to public

44
Q

how many dispensing incidents occur

A

26 for every 22,000 items dispensed

45
Q

Aim of SOPS

A

to ensure that dispensing processes occurred in a safe manner and
also that they could be reviewed to facilitate improvements in
standards; a principle which lies at the very heart of what Clinical
Governance represents

46
Q

SOP

A

specifies in writing what should be
done, when, where and by whom and covers all aspects of a
particular process; step-by-step
ensure consistency in working practice by all staff whether they are regular team members or relief workers

47
Q

components of SOP

A

Title
Objective/Purpose
Scope
Responsibilities
Procedure
Materials/Equipment
Safety Precautions
References

48
Q

When a patient makes a complaint we should ensure

A

complaints are dealt with efficiently;
complaints are properly investigated;
complainants are treated with respect and courtesy;
complainants receive a timely and appropriate response;
assistance to enable them to understand the procedure in relation to complaints; or
advice on where they may obtain such assistance;
complainants are told the outcome of the investigation of their complaint; and
action is taken if necessary in the light of the outcome of a complaint.

49
Q

what happens to reports once they have been received by the NRLS/LFPSE

A

analysed to identify trends and patterns in medication errors. helps in developing strategies to prevent similar errors in future.

50
Q

Root cause analysis

A

Consider contributing factors that led to the error and use question why?

51
Q

Why is revalidation important

A

Helps pharmacists and pharmacy technicians to:
* keep their professional skills and knowledge up to date
* reflect on how to improve
* show how they provide the safe and effective care patients and the public expect, as
set out in the standards for pharmacy professionals

52
Q

Each year as a pharmacist what do you need to carry out, record and submit to GPhC?

A
  • four continued personal development (CPD) records, at least two of which must be
    planned learning activities
  • one reflective account
  • one peer discussion

MPharm Stage 1 (14 decks)

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