Clinical Governance

Question 1

What is clinical governance?

Answer 1

A systematic approach to maintaining and improving the quality of patient care within a health system

Question 2

What are the dimensions of healthcare equality?

Answer 2

• person-centred
• safe
• effective
• efficient
• equitable
• timely

Question 3

What is meant by patient-centred healthcare quality?

Answer 3

Partnership between patient, families and those delivering healthcare which respects individual needs and values and demonstrates compassion, continuity, clear communication and shared decision making

Question 4

What is meant by safe healthcare quality?

Answer 4

• no avoidable injury or harm from healthcare received
• appropriate, clean and safe environment provided for delivery of healthcare services

Question 5

What is meant by effective healthcare quality?

Answer 5

• does the intervention work?
• the most appropriate interventions, support and services provided to everyone

Question 6

What is meant by efficient healthcare quality?

Answer 6

• is the output (benefit) maximised for the given input (costs)?
• wasteful or harmful variation eradicated

Question 7

What is meant by equitable healthcare quality?

Answer 7

• are all patients fairly treated?
• is the distribution of care based on need?
• high quality services provided to everyone, no matter who they are or where they live

Question 8

What is meant by timely healthcare quality?

Answer 8

appropriate treatment, support and services provided at the right time for everyone

Question 9

What factors can contribute to adverse healthcare events occuring?

Answer 9

• human factors such as teamwork, communication, stress and burnout
• structural factors such as reporting systems, infrastructure, workforce loads and the environment
• clinical factors such as complexity of care & length of stay

Question 10

What are the different components that make up clinical governance?

Answer 10

• education & training
• clinical audit
• clinical effectiveness
• research & development
• openness
• risk management

Question 11

What can help ensure that the dimensions of healthcare quality & the clinical governance process are delivered?

Answer 11

• setting quality standards
• delivering quality standards
• monitoring quality standards

Question 12

What is meant by “setting good quality standards” ?

Answer 12

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

Question 13

What is the aim of clinical guidelines?

Answer 13

Aim to improve the quality of healthcare provided

Question 14

What are the uses of clinical guidelines?

Answer 14

• provide recommendations for the treatment & care of individuals
• used to develop standards for clinical audit
• used in education & training of health professionals
• help patients to make informed decisions
• improve communication between patient & health professionals

Question 15

Give examples of clinical guidelines used in Scottish dentistry:

Answer 15

• SIGN guidelines
• NICE
• SDCEP
• Healthcare Improvement Scotland

Question 16

What study type is considered evidence level 1?

Answer 16

Systematic review (cochrane) & RCT

Question 17

What study type is considered evidence level 2?

Answer 17

Cohort

Question 18

What study type is considered evidence level 3?

Answer 18

Case-control

Question 19

What study type is considered evidence level 4?

Answer 19

Case series

Question 20

What study type is considered evidence level 5?

Answer 20

Narrative Review, editorial

Question 21

What is considered the strongest type of scientific evidence?

Answer 21

Meta-analysis & systematic reviews

Question 22

What is considered the weakest type of scientific evidence?

Answer 22

Case reports, opinion papers & letters

Question 23

Give examples of some key clinical governance activities that are carried out to ensure quality standards are maintained in healthcare?

Answer 23

• education & training/CPD of all staff
• risk management
• openness of poor performance & practise

Question 24

What is CPD? How does it apply to dentistry?

Answer 24

Continuing Personal Development
- “the ethical duty of dentists to continue to undertake appropriate continuing education for the duration of their professional practise” (GDC)

Question 25

What is involved in CPD?

Answer 25

Provides NHS staff the opportunity to continuously update their skills & knowledge - eg taking part in educational courses

Question 26

What are the CPD requirements for dentists as set out by the GDC?

Answer 26

100 hours verifiable CPD within 5 year cycle & at least 10 hours verifiable across 2 consecutive years (from 2017 onwards)

Question 27

What is the format of CPD for dentists?

Answer 27

- courses and lectures - training days - peer review - clinical audit - reading journals - attending conferences - E-learning activity

Question 28

What are some CPD topics that are highly recommended by the GDC?

Answer 28

- medical emergencies - disinfection & decontamination - radiography & radiation protection - legal and ethical issues - complaints handling - oral cancer: early detection - safeguarding children and young people

Question 29

What is the function of the Scottish Dental Reference Service (SDRS)?

Answer 29

To monitor quality and probity of dental treatment by reviewing a sample of patients each year

Question 30

What is the definition of a clinical audit?

Answer 30

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 - ensures what should be being done is being done

Question 31

What are the steps involved in a clinical audit ?

Answer 31

- select topic - set agreed standards & decide on data requirements - observe practise & collect data - analyse data & determine any deviation from standard - identify any areas of change required - make necessary changes - repeat audit process

Question 32

Discuss the 5 parts of the audit cycle:

Answer 32

1. identify problem or issue 2. set criteria & standards 3. observe practise / data collection 4. compare performance with criteria & standards 5. implement change