PEPs - Clinical Quality and Evidence

Module 1 - Clinical Quality

Introduction

Image by DarthNick on Flickr

Teacher's Comment

At the end of this first module you should understand:

  • Some measures of quality in Healthcare – but also that efforts to meet targets can have unintended outcomes. Quality initiatives have not always improved patient wellbeing and safety
  • Why safety is important and how effective systems can promote it
  • Your responsibility to engage with patient safety initiatives and to strive to overcome barriers to improving services - including to ‘whistleblow’ if necessary.

The aim of the course is to help you to plan activities that will reinforce your learning on improving safety and your awareness of cultural barriers to achieving this.  It is also important that you use some external links and resources.  This course functions partly by signposting you to other important modules and if you can demonstrate evidence of completion this may contribute to validation of an ‘excellent’ grade for the module, or support a nomination for exceptional achievement. (Note: Some of the links may change with NHS ‘reforms’ but we will endeavour to update them. The indicated study times required for BMJ Learning are very generous and you can download certificates of completion for portfolio).


Access the Institute for Healthcare Improvement ‘Open School’


This offers free certified courses and could also help you network with your colleagues and see what Medical students in other Schools are doing to enhance safety: see for instance the question students asked patients at Cardiff :  ''What Can I Do to Improve Your Care Today?'' - Nursing and Medical students responded to complaints of thirsty patients and also prevented serious medication error:


"These stories are inspiring others to action because they show what is possible through regular inquiry about patients’ needs. The campaign is an encouraging first step for students who can make a big contribution to changing culture and improving the patient experience. Its success does not hinge on technology, finances, rules, or regulations; the campaign relies on dedicated providers to promote a patient-centered culture."


Quote from Institute for Healtcare Improvement


But we should begin by highlighting tensions in the NHS that sadly can overshadow this topic and may seem to dominate debate for years to come.  Then we look at the background to Clinical Quality and Quality Improvement – covered in more detail in Module 4.  While we indicate some important toolkits for systems change in Secondary care, we will then highlight two simple drivers for patient safety that you could investigate yourself in any care setting.


One of these is the SBAR system (Setting Background, Assessment Recommendation / Readback) – designed to structure and improve the clarity of communication in teams.  The second is Significant Event analysis (SEA) or critical incident review.