General Flashcards
Define an audit
The systematic critical analysis of the quality of medical care, including the procedures used for diagnosis & treatment, the use of resources & the resulting outcome & quality of life for the patient
5 stages of an audit
- 1: identify current standards
- 2: measure current performance
- 3: compare performance vs standards
- 4: make improvements
- 5: re-evaluate
3 benefits of an audit
improve patient care, financial benefits, assess progress against national standards
5 limitations of an audit
only as good as national standard, may have no improvement, costs time/money/resources, only focusses on one thing at a time, improvements focus on current standards and not what might actually be best
How long do you have to complain
12 months
3 steps for complaints
1st: PALS
2nd: NHS directly or commissioner
3rd: Parlimentary and health service ombudsman
What is PALS
Patient advise and liaison service
Independent complaints advocacy service in every trust
Complaining about mental health act?
Directly to CQC
Commissioner for hospital and GP
Hospital: NHS England
GP: CCG
4 common reasons for complaints
Ineffective/unsafe clinical practice
Poor information
To have bad practice investigated & changed
Bad attitudes/ lack of dignity and respect.
Define medical indemnity
: legal exemption from liability for damages done to patients under treatment in NHS
4 responsibilities of doctors
discuss everything in non-jargon way, recommend alternative treatments, keep good records, ask for second opinion when knowledge is limited
Define adverse effect
Undesired harmful effect resulting from medication/procedure.
e.g. prescribing error, surgical error, communication failure, delayed diagnosis
Most common adverse effect in primary and secondary care
Primary: delayed diagnosis
Secondary: negligence
Define near miss / active failure
can be errors (knowledge/rule/skills based) or violations (routine, reasoned (thought in patient’s best interest), reckless/malicious)
How many near misses are preventable
50%
Why are near misses important
They’re common, have consequences and we can prevent them by reporting them
Role of the national patient safety agency
responsible for handling adverse events, and they can be reported to them e.g. reporting drug reactions/side effects with yellow card at back of BNF
5 barriers to effective learning
lack of communication, lack of responsibility, focus on event not root cause, pride/rigid attitude, poor monitoring
7 steps to patient safety
Build safety culture, support staff, integrate risk management, promote reporting, communicate public, implement solutions, lean and share
Consent for clinical trials
Must be informed and reviewed by ethics committee
3 ethical issues of clinical trials
Subjecting some people to risk for the benefits of others: does risk-benefit analysis is main job of ethics committee (non-maleficence and beneficence
Not knowing long term damage so is consent informed
If paid money are they taking advantage of pooper populations, will they provide false information to join, removes altruism
What are the 4 stages of a trial
1: researchers test a new drug or treatment for the first time in small number of people (20-80) (usually normal, healthy volunteers, to evaluate its safety, determine dosage range, side effects
2: larger groups (100-300) to further assess clinical safety
3: larger groups (1000-3000) to look for s/e
4: performed after drug or treatment has been authorised for medical prescription and has been marketed. Look for long term use.
Ethical dilemmas towards healthcare problems in the elderly
Conflict of interest, Euthanasia, DNACPR
Consent and capacity
