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Year 3 Human Disease > Clinical Governance > Flashcards

Flashcards in Clinical Governance Deck (24):

what is clinical governance? 3 reasons

system through which NHS organisations are accountable for:
-continuously improving quality of services
-creating an environment in which clinical excellence will flourish


6 pillars of clinical governance +1

-clinical effectiveness
-research and development
-risk management
-education and training
-clinical audit
using information and IT


4 aspects used by WHO

-professional performance (technical quality)
-resource use (eg money, efficiency)
-risk management (risk of injury or illness)
-pt satisfaction


3 aims of clinical governance

policies and approaches to create organisation in which final accountability rests with a body or individual


what paper defined these aims of clinical governance

NHS White Paper 1999


example of why clinical governance has been put in place

TAMOXIFEN: drug used for some breast cancers. only available in some counties
-->clinical governance unified standards


3 objectives that need to be met by governments to provide good clinical governance

-improve continually the overall standards
-reduce unacceptable variations
-ensure best resources so patients receive greatest benefits


3 things care provided should be

-appropriate to peoples needs
-effective - drawing on on best available clinical evidence
-efficient- economic, maximises health gain for population


what 3 things is development of National Guidance based on?

-reliable evidence of clinical cost effectiveness
-experience of health professionals and managers
-values and wishes of patients


why are there problems with NHS research and development strategy?

evidence is rapidly expanding. have to decide between contradictory evidence and lack of evidence
-->blame could often be placed with clinician


what company is meant to solve NHS Research and development issues and how? 6

National Institute for Clinical Evidence (NICE):
-identify new and existing health interventions
-collect evidence
-advise on best practice
-appraise new health interventions
-how they are implemented
-how the


how strict are NICE guidelines? explain, eg

they are only GUIDELINES --> can go outside them. eg guidance is not to extract mesio-angled wisdom teeth unless proof of infection or caries, but waiting for this proof destroys the 2nd molar


purpose of national service frameworks

set out what patients can expect from NHS, eg waiting time limits for cancer treatments, centralisation of rare procedures eg cleft palate to ensure high standard


what does clinical governance encourage in a working environment

-open and participative --> no blame on individuals
-ideas and good practice are shared
-education and research are valued


why does clinical governance encourage these things in working environments?

-modernise and strengthen professional self-regulation
-build on principle of performance review
-strengthen existing systems of quality control
-use evidence based practice
-learn lessons of poor performance (assess and minimise risk of untoward events, investigate problems as they arise)


3 ways to ensure delivery of high quality healthcare

-clinical governance
-professional self-regulation
-lifelong learning


explain how lifelong learning works for dentists

Continued Professional Development CPD:
assurance that treatment is up to date, effective, good level clinical skills
GDC monitor both verified and unverified CPD hours


5 elements of professional self-regulation

-legitimate public health expectations (NHS regulations)
-realities of service delivery (eg complaints procedures)
-professional regulatory bodies (GDC)
-conduct and scrutiny (alcohol and drug problems)
-whistle blowing (informing GDC of unprofessionalism of colleagues)


how do we monitor quality standards?

-Care Quality Commission CQC statutory body(formerly healthcare commission, commission for health improvement).
-provides national framework for assessing performance/checks its implemented
-undertakes annual national survey of patient and user experience
-visits all trusts and PCTs
-checks NICE guidelines are implemented
-endorses external clinical audits
-independent review of local action


what can the CQC do when standards arent being met? 3

-issue fines/ warnings
-stop admissions in to a care service
-suspend/cancel a care services registration


4 ways CQC involvement can be triggered

-alarm bells at local levels
-PCTs and PCGs invite CQC when local action has failed
-referring individual clinicians to professional organisations
-external incident review


6 areas looked at in National Framework for Assessing Performance

value for money and quality in:
-health improvement
-fair access to services
-effective delivery of healthcare
-patient and carer experience
-health outcomes of NHS care


uses of National Framework for Assessing Performance's published clinical information

-allows hospitals and public to compare performance
-identification of valid quality indicators
-impacts on delivery of clinical procedures at GDP level


what feedback is included in National Survey of Patient and User experience? 4

-NHS complaint procedures
-Community Health Council
-Patient Surveys
-Review of Regional Office action to local issues