AUDIOLOGY PRACTICE IN A CLINICAL GOVERNANCE FRAMEWORK

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AUDIOLOGY PRACTICE IN A CLINICAL GOVERNANCE
FRAMEWORK

• Dr. Louise Girardier
• RGN RSCN MSc PhD
• Head of Clinical Effectiveness
• Hull East Yorkshire Hospitals
• NHS Trust

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AIMS OF PAIG

• To promote good working practice in Paediatric
  Audiology to meet the individual needs of the
  child and the child's family
• To work towards consistent and effective quality
  provision of services in the UK
• To foster multi-agency working through meetings,
  discussion groups and other communication methods
  
• To encourage research, development and
  circulation of information relevant to the work
  of the Group

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Audiology background process

• One baby in 500 has a permanent hearing
  impairment
• affects development of speech language, with
  consequences for general development
  educational outcome.
• Diagnosis
• Assessment
• Intervention
• Evaluation
• All underpinned by
• professional standards and guidance including
  protocols
• theoretical Knowledge gained through education
  and training
• experiential knowledge through professional
  development
• audit and research

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The Audiologists Role?

• Consultant, advisor, supervisor, educator,
  facilitator and researcher
• Provides
• Information and support
• Communication
• Counselling
• Diagnosis
• Investigations
• Assessment
• Intervention
• Evaluation of effectiveness and efficiency
• Safety and risk management
• Quality improvement

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Audiology Practice

• Assessment and rehabilitation
• based on sound clinical evidence of the efficacy
  and effectiveness of different methods of service
  provision.
• the efficacy and effectiveness of assessment and
  treatment procedures underpin the choice of
  clinical activity.

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Practice Philosophy Principles

• Selection from a range of assessments
• Record and document assessments accurately
• Evaluate the individual in terms of needs
  context.
• Develop therapeutic relationships
• Assessing using appropriate methods of
  communication
• Understanding different models of disability
  which informs the philosophy and principles of
  intervention

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Clinical Governance

• Mechanism within health services or ensuring care
  is
• Safe
• Effective
• Efficient
• Continually improving
• Focused on
• improving patient care
• Improving the patient experience
• protecting staff
• protecting the organisation

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Clinical Governance Systems

• Knowledge Information management
• to systematically identify problems
• enables recognition of the need for change
• explores the potential for change
• facilitates implementation of agreed tactics
• supports consolidation
• monitors outputs and impacts
• Provides strategies for change (within the NHS)

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Setting Standards

• Policies and Protocols
• Must do
• Clinical guidelines and standards
• an integral component of clinical governance and
  practice
• require robust evaluation of evidence and advice
  given
• they are not intended to restrict clinical
  freedom, but practitioners are expected to use
  the recommendations as a basis for their
  practice.
• local resources and the circumstances and
  preferences of individual patients also need to
  be taken into account

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Types of guidance

• National
• DH NHS NICE
• Professional organisations
• Organisational
• Policies
• Protocols
• Standards
• Guidelines
• Individual practice

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Where are health organisations now?

• Major changes are occurring
• Centrally in NHS Trusts
• support for clinical governance
• staff with knowledge skills
• key staff to lead a programme of change
• resources (whilst limited)
• Next steps
• translating central strategy plans
• into action, that enhances services to patients

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However.. Be aware

• Integrated governance balanced portfolio
• Finance
• Performance
• Quality
• Healthcare standards
• CNST
• Research governance
• Subtle shift from Strategic QI to RM
• Adaptation or extinction?

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Balancing Protocols with Reality Making
Connections

• Having a strategy
• using tactics to convert this into operational
  action for all
• Making connections
• across all themes of clinical governance
• in all divisions and departments
• Providing evidence of effectiveness
• Organisation
• Strategic business and operational
• Children, parents and carers
• Professional perspective

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Audiology and Clinical Governance

• Strategy and plans (aspirations)
• If NHS these must be linked to Healthcare
  Standards
• Clear objectives
• Timescale
• Monitoring
• Evaluation
• Reporting
• Evidence of effectiveness and efficiency
• Quality Improvement
• Cost improvements
• Learning
• If not NHS then there will be a QI system

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CG.. the framework

• Leadership, strategy and planning
• Management and organisation of services
• Risk Management (clinical and financial)
• Incident reporting
• Risk Assessment
• Health Safety
• Clinical Standards
• Improving the patients experience
• Patient and Public Involvement and Learning from
  patients
• Clinical Audit, Research and Effectiveness
• Staff focus
• Staffing and management
• Education Training
• Use of Information and resources

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Standards for Better Health

• Concordat on Health service accreditation
• Standards for Better Health
• CNST
• PPI framework
• NICE
• NSF
• Template for Change
• Maximise on positives
• Re-map to new NHS quality improvement systems

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Standards for Better Health

• Standards For Better Health
• Two principle objectives
• Common set of requirements
• Framework for Continuous Improvement
• New quality improvement programme
• Underpinned by the unifying concept of CG
• Systematic means for ensuring organisations
  comply with their statutory duty

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Standards for Better Health

• Seven domains with specific outcomes
• Safety
• Clinical and Cost Effectiveness
• NICE and NSFs are integral to the standards
• Governance
• Patient Focus
• Accessible and Responsive Care
• Care Environment Amenities
• Public Health