clinical governance dr lisa joels postgraduate organiser singleton hospital 6 th august 2008
TRANSCRIPT
Clinical Governance
Dr Lisa Joels
Postgraduate Organiser
Singleton Hospital
6th August 2008
Clinical Governance
Risk management Avoiding adverse incidents Education & CPD Protocols & Guidelines Communication skills Consent Complaints procedure
Notes and coding Audit
Risk management
Adverse incidents: Avoidable
MistakesErrors
UnavoidableE.g inevitable bad outcomes
How to avoid adverse incidents
Keep up to date
Education and CPD
Teaching programme in Singleton Library On line resources Study leave Locally run courses
Avoiding adverse incidents
Keep up to date Use protocols and guidelines
Protocols and guidelines
NICE guidelines Royal College guidelines All Wales guidelines & pathways Local protocols
Paper protocolsIntranet based protocols
MOCIS Junior Medical Staff Handbook
Avoiding adverse incidents
Keep up to date Use protocols and guidelines Communication skills
Communication skills
Local trainingBreaking bad newsDealing with difficult patients
• Violence and aggression training
Communication skills workshop• Local courses• Royal Colleges
Avoiding adverse incidents
Keep up to date Use protocols and guidelines Communication skills Consent
Consent
May be: Tacit
E.g holds arm out for blood test Verbal
E.g intimate examination(document in notes – self defence)
Written
Taking consent
All Wales consent forms 4 forms
Patient’s consentParental consent on behalf of child
(<16)Procedure where consciousness not
impairedAdults unable to consent
Consent
Good practice – when to consentComplex or risky procedure or
treatmentAnaesthesia or sedationPossible significant consequencesResearch
Consent
Forms require statements of:Intended benefitPossible serious harmAny extra procedures which may
become necessaryConfirmation of alternatives discussed
– including no treatment Do not try to take consent if you can’t
fully discuss the issues above
Consent and Mental Capacity Act 2005 MCA 2005 requires that capacity be
considered when taking consent Presumption of capacity Functional test
Understand informationRetain informationWeigh up informationCommunicate decision
MCA 2005
5 principlesRight to make own decisionsEvery effort to support decisionRight to make unwise decisionBest interestsLeast restrictive of basic rights
Junior Staff Handbook – Consent GMC Consent:patients & doctors making
decisions together
Avoiding adverse incidents
Keep up to date Use protocols and guidelines Communication skills Consent Keep good notes
Keep good notes
Legible Black ink (biro) All entries dated and timed All entries signed
Use stamp with GMC numberPrint namePrint bleep number and designation
Discharge summaries
What to do if involved in adverse incident Inform senior colleague Fill in incident form KEEP GOOD NOTES Respond to complaints
Factual account Timely responseTake senior adviceContact defence organisation
Clinical Governance
Risk management Avoiding adverse incidents Education & CPD Guidelines & protocols Communication skills Consent Complaints procedure
Notes and coding Audit Appraisal & revalidation
If you have problems……
Educational Supervisor Clinical Director Medical Director Bruce
Ferguson Postgraduate Organiser Lisa Joels Occupational Health Mike Tidley
Chief Executive Paul Williams