Quality Assurance Flashcards

(51 cards)

1
Q

Name the five different views of what makes a good dentist?

A
Dental view
Patient view
PCT (NHS commissioning view)
Dental Hospital View
Staff View
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2
Q

What is the dental view to what makes a good dentist?

A

Good clinical ability

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3
Q

What is the patient view of what makes a good dentist?

A

Pain free
seen on time
reasonble cost

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4
Q

What is the PCT view of what makes a good dentist?

A

Passes inspections
low/no complaints
FUlfil contractual obligations
Few emergencies

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5
Q

What is the dental hospital view of what makes a good dentist?

A

Appropriate referrals

Good quality referral letters

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6
Q

What is the staff view of what makes a good dentist?

A

Polite and considerate
Sees patients on time
personal development
Health and Safety

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7
Q

What are the 2 main ways of assessing the quality of healthcare?

A

Maxwells dimensions of quality

Donabedians Approach to evaluation of a system

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8
Q

What are maxwells 6 dimensions of quality? reference

A
  1. Access to services
  2. Relevance to need
  3. Social Acceptibilty
  4. Effectiveness
  5. Equity
  6. Efficiency and Economy
    Maxwell R 1984
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9
Q

What does access refer to according to maxwell?

A

Opening hour
location
any obvious barriers to service
can people get treatment when they need it

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10
Q

what does relevance refer to according to maxwell?

A

Is the balance of services the best that could be achieved when considering needs and wants of the whole population?

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11
Q

What does effectiveness refer to according to maxwell?

A

Is the treatment given evidence based an the best treatment available

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12
Q

What does the term equity refer according to maxwell?

A

are patients being fairly treated?

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13
Q

WHat does the term acceptability refer to according to maxwell?

A

How humanely and considerably is the treatment delivered, are confidentiality safeguarded?

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14
Q

What does the term efficiency refer to according to maxwell?

A

is the output maximised for the given input

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15
Q

Give an example where maxwells dimnsions of quality can be applied

A

Cleft lip and palate services in the UK

outcome of unilateral cleft lip and palate at aged 5 1998 showed:
40% poor dental arch relations and untreated caries
19% impossible to understand
Access to services was poor since services were centralised from 57 to 18 centres

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16
Q

What does Donabedian look at?

A

an approach to evaluation of a system

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17
Q

What three things are important to consider when evaluating an system?

A

structure: skills of the staff, the buildings and premises, and the equipment the organisation makes available
process: the methods that are adopted by the organisation to provide its services

outcome

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18
Q

What is usually used in Donabedians system instead of outcome and why?

A

output

because outcome is difficult to measure

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19
Q

Apply Donabedians system to cleft lip and palate?

A

structure: This considers the buildings, number of staff
Process: number of pateints treated and waiting times
Outcome: appearance, speech

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20
Q

What can be out in place for quality assurance?

A

A quality framework which is comprised of three stages:

Set standards
Local delivery
Monitoring

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21
Q

What kind of bodies set quality standards?

22
Q

What kind of bodies ensure quality is delivered locally?

A

Clinical Governance

23
Q

What kind of bodies and reports monitor quality?

A

CQC
Dental reference services
Vital signs report

24
Q

What is clinical governance?

A

Scally and Donaldson 1998

A framework through which

NHS organisations are accountable for continuously improving the quality of their services

and

safe-guarding the high standards of care

by creating an environment in which excellence in clinical care will flourish

25
WHat 5 things are done to ensure clinical governance for GDP's are being carried out?
``` Clinical audit/peer review CPD Clinical Risk management Complaints procedure Addressing under performanece ```
26
How often do clinical audits and peer reviews need to be performed?
15 hours every 3 years
27
How much CPD need to be done?
75 hours verifiable 175 hours non verifiable every 5 years
28
What does clinical risk management consider?
compliance with statutory regulations, staff protection and critical event audit
29
What features must a complaints procedure have?
an in house system | reasonable time frame
30
What must be in place for addressing under performance?
whistle blowing policy
31
Who is responsible for addressing under performance?
all members of the team
32
According to Lord Darzi 2008 what are the domains of quality?
safety effectivenss patient experience
33
What changes did Lord Darzi's report on high qualiy care for all have on dental practices?
all practices were as a result are now monitored by CQC where as prevsiously private practices were exepmt
34
WHat 7 bodies are responsible for quality of dentistry?
``` PCT GDC Dental services division of BSA CQC National clinical assessment service Colleagues and members of team Yourselves ```
35
What is the role of the PCT in ensuring quality?
They monitor contracts and assess performances
36
WHat is the role of the GDC in ensuring quality?
fitness to practice CPD registatrion private patient complaints
37
What is the role of the BSA in ensuring quality?
monitor and advise on quality
38
What is the role of nastional clinical assessment service ensuring quality?
support service, and concerns over the performance of a dentist
39
What is the role of colleagues and team in ensuring quality?
ensure adhernence to regulation and raise concerns
40
When was the CQC est?
April 2009
41
WHat is the role of the CQC?
to act as an independant regulator of health and social care services
42
What do the CQC perform annually?
health checks looking at a. Quality of services :using performance indicators and compliance with core standards b. financial management
43
What do CQC produce at the end of their health checks?
special reports
44
What do PCT's use when assessing quality?
they use performance indicators
45
What performance indicators are used by PCT's?
``` CQC reports referrals to secondary care PALS Critical incidents Whislt blowing CLinical audit random patient questionnaires given by DSD of BSA ```
46
What is the purpose of the DSD of BSA?
ensures NHS treatment is necessary and carried out at a satisfactory level
47
What do the DSD do?
they perform targeted practice inspections at the request of PCT in England but regular inspecions in Wales
48
What report to DSD produce?
Vital signs report
49
What us the purpose of vital signs repsort?
set of metrics monitoring key aspects of delivery of primary care dentistry
50
What are the 7 indicators of quality used in the vital signs report?
``` percentage of those: re-attending in 3 months urgent treatment free repair/replacement continuations satisfied with treatment recieved satisfied with time to wait for treatment ```
51
How can the donabedian approach and maxwells dimensions of care be combined?
They can be combined to form the wright marrix