HaDSoc Flashcards
(54 cards)
What is high quality healthcare?
Safe, effective, timely, efficient and equitable
Explain what clinical governance means
A framework through which NHS organisations are accountable for continuously improving the quality and safeguarding high standards of care
Define equity
Everyone with the same need gets the same care
What evidence is there that care isn’t optimal?
There is variation
In terms of harm, define adverse effect and preventable
Injury caused by medical management not the underlying disease - first time giving a drug and the patient reacts to it
Adverse effect which could be prevented given current medical knowledge - wrong operation/dose
Explain the Swiss cheese model
There are successive layers of defences/barriers/safeguards which have holes in due t active failures or latent conditions. If all the holes “line up” then harm may occur
What is the difference between an active failure and a latent condition?
Acts which lead to patient harm - wrong dose
Something which makes active failures more likely - poor training
What organisations and policies encourage quality in the NHS?
NHS outcomes framework - outcome goals linked to finance
NICE quality standards - markers of high quality, clinical, cost effective care
Clinical commissioning groups, commissioning outcomes framework, quality and outcomes framework, quality accounts, care quality commission, audit
Explain how a systems based approach can promote better healthcare
Remove human factors such as: avoid reliance on memory, visible things, simplify, standardise, checklists, less vigilance needed
What are some types of quantitative research?
RCT, cohort, case control study
Secondary statistics - census or other national/regionally collected statistics
What are the pros and cons of quantitative research?
Good - describing, measuring, finding relationships and comparing
Bad - forced into inappropriate category, don’t get all info and can’t establish causality
What is qualitative research?
Make sense of phenomena such as why people don’t stop smoking or what it’s like to have arthritis
How can qualitative research be collected?
Observation/ethnography
Interviews
Focus groups
Documentary/media analysis
What is qualitative research good and bad for?
Good - understand perspectives, access non quantitative information and explain relationship
Bad - finding relationships and can lead to generalisations as small groups
What is evidence based practise?
Integrate individual clinical expertise with best external evidence from research
What are some practical and philosophical criticisms of evidence based practise?
Can’t maintain all systemic reviews and can’t always use good RCTs
May not apply to individual patient, legitimise rationing leading to distrust, doctors become “rule followers”
What are the difficulties of establishing based practise?
Unavailable research
Doctors don’t know about or use research
System doesn’t support innovation
Patient wants something else
What five factors in regards to diversity affect health?
Ethnicity, gender, age, disability and homeless
Why might ethnicity affect health?
Health related behaviours
Discrimination in services
Genetics
What are the 6 explanations for inequalities in health?
Artefact-data collection
Social selection-sick people become more deprived
Behavioural/cultural-due to people’s choices based on background
Materialist-lack of resources or increased exposure to hazards
Psychosocial-deprived have more stressors
Income distribution-more inequality means more threat so more stress
What are lay beliefs?
Beliefs constructed by people with no specialised knowledge to understand health and illness
What is health behaviour?
Activity undertaken to maintain health/prevent illness
What is illness behaviour?
Activity of ill person to define illness and seek solution
What is the illness iceberg?
Most symptoms never get to a doctor
