Clinical Governance for Dummies: Guest post with Elizabeth Offen

A pleasure to feature this guest post from Elizabeth Offen...

Elizabeth graduated from Sheffield Dental School in 2019. She currently works as a DFT in Sheffield. With DCT interviews around the corner, Elizabeth thought it would be useful to provide an overview of clinical governance in dentistry. 



Clinical Governance: What is it?


Clinical Governance is a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.” (Scally and Donaldson, 1998)

Clinical governance allows us to continuously monitor and improve our service. It is a framework for quality improvement and can be divided into:

  1. Setting Standards
  2. Monitoring them


Setting standards is based on:
Monitoring standards involves:
Clinical effectiveness & evidence-based dentistry
Risk management
Significant event analysis
Audit
Education/CPD
Self-assessment and peer review
Public involvement

Setting Standards


Clinical effectiveness & evidence-based dentistry


Clinical effectiveness measures how successful a service is. This can include assessing its outcomes, safety, cost effectivity.
Sources such as the Cochrane Library provide a robust evidence base. Organisations such as NICE provide authoritative guidance on current best practice.

Risk management


Risk management aims to reduce the chance of adverse events. Examples include:
  • Following local safety policies
  • Learning from complaints
  • Using the correct PPE
  • Creating a safe working environment

Significant event analysis


Unlike risk management, which involves assessing potential consequences before they occur, significant event analysis involves reflecting upon an event after it has occurred.




Monitoring standards


The CQC monitors healthcare providers to ensure that they are carrying our clinical governance.

Audit

NICE define audit as:

… a quality improvement process that seeks to improve patient care and outcomes through systematic review of care and the implementation of change.

To conduct an audit:

Propose a topic
Collect data
Select an accepted standard
Analyse data
Implement changes
Complete a second audit cycle

Education

As stated in the GDC standards:

“…7.3 You must update and develop your professional knowledge and skills throughout your working life…”

GDC Development Outcomes

A Communication
B Management and Leadership
C Development of knowledge
D Professionalism

In January 2018, the GDC introduced enhanced CPD.



Min. requirements of verifiable CPD (in 5 years)
Dentist
100 hours
Dental hygienist/therapist
75 hours
Dental nurse/technician
50 hours


Peer review


Sharing experiences between peers and reflecting on how to improve the outcomes. Can be used to identify CPD needs or deficiencies in policies.

Public involvement


e.g. patient satisfaction surveys, like Friends and Family test.

So not only do you need to know this for interviews... when used effectively, clinical governance plays an important role in improving the quality of services and patient outcomes!



Thanks Elizabeth for your awesome summary, I'm sure many will find it useful when preparing for their interviews!


Do you have any questions about dental core training? Let me know in the comments below. 




References
General Dental Council UK, 2018. Enhanced CPD Guidance for Professionals.
General Dental Council UK, 2013. Standards for the dental team.
Scally, G. and Donaldson, L.J., 1998. Clinical governance and the drive for quality improvement in the new NHS in England. Bmj, 317(7150), pp.61-65.

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