Leadership and Governance Flashcards
values and principles, time management, workload management, leadership, managed care networks, appraisals, recruitment policies, sickness policy, harrassment and grievance policies, complaints, audit, performance standards, funding structures, financial reports, budget and purchasing
what is clinical audit
Quality improvement process
Seeks to improve patient care and outcome
Systematic review of care
Against explicit set of criteria or standards
Implement change
Review
What is the difference between research and audit?
Research seeks to find answers to new questions - often by comparing groups
Audit uses existing knowledge and ensure current meets existing standards based on current evidence.
Research = discovering the right thing to do
Audit = ensuring the right thing is done
Steps of the audit cycle
- identify problem
- set standards - guidelines, evidence, consensus
- assess or measure quality - data collection
- identify change required - why are standards not met
- implement change
- monitor effects of change
How can healthcare be measured
Efficacy - does it work Effectiveness - how well does it work efficiency equality / equity accessibility acceptability appropriateness (meeting needs)
What is clinical governance?
A systematic approach to safeguarding and maintaining quality in healthcare
Accountability for healthcare
Integrated approach to achieve high quality
An enabling environment to implement changes to improve and maintain quality
Main elements of clinical governance
risk management education and training Continuous professional development clinical audit clinical effectiveness information management and communications patient and public involvement strategic leadership and workforce planning
Steps in defining a service ‘problem’
e.g. local target not met
Consider
- premises +/- access issues, opening times etc
- patient referral pathway +/- time delays
- initial contact and booking process
- patient demographics
- presenting conditions
- recording of data
- patient management - which staff, what training
- staff access to medications and investigations
- diagnostic availability and treatment options
- adverse event recording and outcomes
- onward referral pathway
What are the 10 aspects of safety culture from the Manchester Patient Safety Framework
- Commitment to continuous improvement
- priority given to safety
- system errors and individual responsibility
- recording incidents and best practice
- evaluating incidences and best practice
- learning and effecting change
- communication about safety issues
- Personel management and safety issues
- staff education and training
- team working
What information / methods can be used to improve a service
Gather patient feedback Identify gaps in services or between services. Business case to fill gap. Audit Identify areas for improvement implement changes Monitor changes and if targets are met Scoping exercises Bidding for funding Review other services Negotiation for service level agreements - CCGs and LA Clinical supervision and training Regular training and updates for staff
