Clinical Governance

Clinical governance includes things like clinical audit, risk management, evidence based practice patient input and feedback, clinical supervision, continuing professional development and reflective practice.

Together the different elements of clinical governance:

• Ensure that health professionals have the right education, training, skills and competencies to deliver the care needed by patients
• Ensure that process which improve the quality of care are in place throughout the organisation
• Use techniques to anticipate and prevent potential problems
• Use techniques, to monitor and improve existing practice
• Recognise and act on poor performance, providing a framework, which allows clinical staff to learn from mistakes
• Facilitate the implementation of good practice

The operation's director, managers for each area, administration manager and clinical governance support assistant meet regularly to review the current issues within clinical governance framework for Rehabilitation.

This covers wide ranging areas for example risk assessment, health and safety, patient and public involvement and clinical audit to list just a few. A key part of this process is to identify transferable learning points so that improvements developed in one area can be implemented in others, increasing the benefits across the department.

One example of this approach is where successful strategies for reducing the incidence of non-attendance at out patient clinics developed in one area are being deployed across the department.

Clinical Audit

Clinical audit is a clinically led initiative which seeks to improve the outcomes of patients care through structured peer review whereby clinicians examine their practice and results against agreed standards and modify their practice where indicated.

All NHS trusts must have a clinical governance function to look after the management and efficiency of clinical activities. One part of this is clinical audit - looking at the work we do, checking that it is effective, and changing things if necessary.

In Bradford, the rehabilitation service has a dedicated member of staff to work with the clinicians to continually review and monitor the service provided. A key part of this is making sure that high standards are set and achieved, and analysis of our performance in all areas is ongoing.

Here are the results of some of our audits in Physiotherapy:

In our annual consumer survey over 94% of those questioned rated our service as good or very good. 201 patients at St Luke's and Bradford Royal Infirmary were asked to rate such factors as helpfulness of staff, treatment received, privacy during treatment and efficiency of service and gave an overwhelming positive response.

Some patient's comments

Impressed by the physiotherapist getting to the cause of the problem and treating it quickly.

The service is extremely efficient.

Friendly, helpful staff willing to listen to any problems. Whatever our patients tell us, we aim to please. A service to be proud of.

Patient Information Audit

During June 2005 we asked patients at random on the information they received from the physiotherapy service.

All patients said the information provided was clear and easy to understand.

79% of patients had access to information on the "did not attend" policy, consent to treatment, complaints procedure, transport and hazards related to clinical care eg pacemakers.

83% of patients thought that information provided is available in appropriate language for users.

93% of patients said there was information available that helped them make informed choices.

All staff have been reminded on how important it is to ensure patients receive a copy of the physiotherapy charter giving them information on the physiotherapy service.

Individual Approach Audit

Patients were asked at random the following questions on their individual needs.

Overall 98% of patients said their individual needs were being met.

Some ongoing audits are:

• Review of documentation in physiotherapy patient records
• Patient satisfaction survey of the Parkinson Disease Group
• Monitoring the patients who do not attend or are unable to attend appointments
• Use of the treadmill for neurological patients

New Partners – New Practices A Multidisciplinary Conference Fieldhouse, Bradford Royal Infirmary November 2005

This conference was organised to help share good practice and stimulate interest in developing new approaches to care, in particular, by involving users in service re-design.

Approximately 65 delegates from health care professionals, Trust membership and Directors of the Trust attended the conference on 23rd November 2005 and 48 questionnaires were returned out of 65.

• 91% of delegates strongly agree / agree that the conference has increased their interest in the development of health care practice
• 96% of delegates felt it was worth attending the conference

There was a total of 9 presentations during the day on:-

• Bradford and Airedale Nutrition Network
• Bone Marrow Biopsy – Not a Laughing Matter
• timulating Learning with Simulated Patients
• Development of Rehabilitation Website
• Cancer Services User Involvement Project
• Do Patients Want to be Asked About Resuscitation
• Through Whose Eyes
• Family Summer Schools for Children with Dyspraxia
• Working With Your PALS

90% of delegates strongly agree / agree that they enjoyed the presentations and thought they were well presented.

Some Comments From Delegates

• A thought-provoking day. A snapshot of good work going on in the Trust and I would think this serves as encouragement to all staff who have attended
• The whole day was an enlightening and interesting experience. The lunch provided was excellent, I enjoyed the day and look forward to the next conference
• Excellent forum for sharing ideas, inspiration and innovation
• I have found this very useful especially for me as vice chair of Patient and Public Hospital Involvement Forum. I will do a feedback report for the forum. It will also be useful for me in the different arena's I am involved in which I take forward neighbourhood / community perspectives
• An interesting day. Very informative getting to know what other areas are doing within the Trust to improve patient care. Very positive

However

• The chairs in the room are uncomfortable. Having had a hip replacement I find it difficult to sit still and have had to fold my coat to use as a cushion.
• £5 car parking fee exorbitant - complimentary parking disc should be provided. Seating hard after a long time sitting. Enjoyed day very much
• It would be nice to be able to have water to drink at breaks and lunch