Clinical Governance and Audit Flashcards
(15 cards)
Definition of Clinical Audit
Clinical Audit is 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. Aspects of the structure, processes and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated, changes are implemented at an individual, team or service level and further monitoring is used to confirm improvement in healthcare delivery
Name the SIX stages of the audit cycle
- Identify the issue or problem
- Identify a standard to compare
- Collect data on current practice
- Assess conformity of clinical practice to standard
- Implementing change
- Re-audit
What are the benefits of completing an audit? (3)
- KEY pillar of clinical governance - ensures quality of care and is maintained at an agreed standard
- Encourages the service to make better use of resources and therefore be more efficient.
3.Data gathering can be used:
-inform patients of standard of care
-feed appraisal and assessment process
-demonstrate to trust/managers that system is working efficiently
-share information with other trusts - Training for junior members of staff - learn about service improvement and quality of service provision.
Issues associated with audits? (3)
- Local process - only reach improvement at local level
- Based on retrospective data, can lead to discrepancies and recording bias
- Audits often carried out by clinicians: can’t focus all of time to this and may be inexperienced in this, delaying implementation of change
Difference between research and audit
Audit: compares clinical practice with set standard. i.e an evaluation of compliance with agreed practice that is current.
Research: aims to create new knowledge to be able to develop new standards. ie finding if new methods of care are better than current.
Definition of clinical governance
-easier way to explain this…
A framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.
CG is a quality assurance process, designed to ensure that standards of care are maintained and improved and that the NHS is accountable to the public.
7 Pillars of clinical governance
- clinical effectiveness and research
- Audit
- Risk management
- Education and training
- Patient/Public involvement (PPI)
- Information and IT
- Staffing and staff management
Pneumonic to help remember 7 pillars of CG
PIRATES
SPAREIT
Explain the ‘clinical effectiveness & research’ as a pillar of CG
-how can I be a part of this
- Adopting an evidence based approach
- Implementing guidance and conducting research to further and develop evidence that is available to guide care to patients
-played a role in implementation of new guidelines or facilitating use of guidelines in a department
-case reports or research experience
Explain the ‘Audit’ as a pillar of CG
Being able to continuously monitor clinical practice and identify deficiencies or errors in care - these are remedied in relation to agreed standards
-participated in audit or improve clinical practice
Explain the ‘Risk management’ as a pillar of CG
Involves a system to understand, monitor and minimise risks to patients. This allows staff to learn from near misses and mistakes.
-complying with protocols
-learn from mistakes and near misses with a community of understanding and reflection on practice.
-reporting adverse events
-Assessing risk with focus on likelihood and impact and implementing processes to reduce these
-BLAME FREE CULTURE
-checking correct protocol eg checking dates and labels
-seek help from others
Explain the ‘education and training’ as a pillar of CG
Keeping knowledge and technology is up to date - CPD!!
-courses and conferences
-Taking further exams
-regular workplace based assessment in training
-PDP use
-Attend courses or CPD
-identify weaknesses in practice and act to correct this
Explain the ‘patient/public involvement (PPI)’ as a pillar of CG
Improvements made from patients’ perspective and public involvement in the development of the services.
-patient questionnaires
-Patient Advice and Liaison Service (PALS)
-National patient surveys organised by healthcare commission
-audit of patient satisfaction
-design a questionnaire for patient feedback
Explain the ‘information and IT’ as a pillar of CG
Ensures patients’ data is protected
-up to date and accurate
-data used to measure quality of outcomes
-anonymise patient data for audit
-correct patient records if errors found
-gained IT skills in databases or web
Explain the ‘staffing and staff management’ as a pillar of CG
Appropriate recruitment and management of staff
-ensuring identifying underperformance
-encouraging staff retention: motivation and development
-providing good working conditions
-discuss performance issues with a colleague or reporting this to a senior
-taken steps to improve working relationships
