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Governance of HP
Governance of Hospital Pharmacy Practice
| Question | Answer |
|---|---|
| What are the four elements of clinical governance? | Clinical governance Financial governance Risk governance Other governance (HR, legal etc) |
| Give a brief explanation of WA public hospital governance | Minister for health delegates to the department of health. Director general of the department of health oversees the public health service providers. Each of these service providers have a board and chief executive who run the hospital. |
| What are the roles of the health minister? | Gives instructions to the health department Appints/removes all board members Designates chairs and deputy chairs of the board Can appoint advisers or adminisstrators. Establishes/dissolves and gives directions to hosp boards |
| What is the relationship between the director general of the health department and the service providers? | Gives system wide plans and policies to the hospitals, enter into service agreements, DG issues frameworks and directions to the boards and chief executive. |
| What are the roles of a systems manager? | Monitors performance, takes remedial action Strategic leadership, planning and direction Arranges health services by contracted health entities Budget allocation Oversees, monitors, promotes improvements in safety/quality Assurance |
| Who are the health service providers governed by? | The boards appointed by the health minister Chief executives manage day to day hospital operations |
| What is the theory behind devolved governance of HSP's? | Enable decision making closer to service delivery and patient care |
| What do HSPs do? | Consult with health professionals, health consumers and communities on provision of health services. Cooperate with other providers for planning and providing health services. |
| What does the board of a HSP do? | Governing body establishes a strategic/policy framework Delegates operations to the CEO, who delegates to the workforce Supervises CEO performance Monitors performance of the organisation, ensures focus on continuous improvement |
| What are the responsibilities of the board? | Conform/comply with relevant legislation, standards, accountabile to stakeholders Monitor performance Form and approve policy, aprrove budgets and resources, set KPI's, review CEO performance, manage board committees |
| How are the board responsibilities divided? | 4 essential elements: understand public sector operating environment, know difference between strategy and operations, build effective relationships with external/internal s/holders form appropriate board structure and performance framework. |
| What is the definition of clinical governance? | The set of relationships and responsibilities established by a HSO between the dept of health, governing body, executive, workforce, patients, consumers and other stakeholdeers, to ensure good clinical outcomes. |
| Why is clinical governance important? | Ensures the community and HSO can be confident that systems are in place to deliver safe and high quality health care, and continously improve services. |
| What are the four pillars of clinical governance? | Consumer value, clinical performance and evaluation, clinical risk, professional development and management |
| Which comittes within hospital governance are likely to have a pharmacist involved? | Falls prevention and management Clinical handover, medication safety, antimicrobial stewardship, clinical forms, drugs and therapeutics, health information management, policy, ICT workflow governance, automated medicines management, clinical gov and exec |
| List the medication governance systems | Drugs+therapeutics committee, medication safety committee, policy committee, health information mngmnt, clinical governance, clinical alert, clinical handover, credentialing, antimicrobial stewardship |
| Of the medication governance systems, which one is the peak committee? | Drugs and therapeutics committee |
| What are the functions of the drugs and therapeutics committee? part 1 | Decides on functions to undertake as priority advises medical staff, admin and pharmacy, develops drug policies, evaluates and selects meds for formulary, develops standard treatment g/lines, assesses medicine use to find problems, improves med use |
| What are the functions of the drugs and therapeutics committee? part 2 | manages adverse drug reactions, manages medication errors, information dissemination and transparency. |
| In continuous quality improvement, what are the 4 areas that determine priority? | 1. error reporting (trends + sentinel events) 2. Audit findings from internal and external findings 3. risk reporting and rating 4. consumer feedback |
| What are the principles of error reporting? | Transparency, accountability, probity/fairness, open just culture, obligation to act, prioritisation of events |
| Which one of the severity assessment codes is most significant? | Sac 1 |
| What are sentinel events? | Events that result in serious patient harm or death (medication error resulting in serious harm or death) |
| What is the learning process from a Sac 1 event? | Formal process with reporting to HSP board Managed by quality, safety and performance team Informed by clinicians 'No blame" Share lessons learnt Implement and evaluate recommendations |
| What is the process from a Sac 2/3 event? | Managed by clinicians, recommendations are implemented |
| Why are audits performed in general? | To ensure compliance and monitor impact |
| Who should perform audits? | Preferably someone independent of the system but with knowledge or understanding of the system. |
| Who can perform external audits? | Office of the auditor general - state supply regs ACQSH -accreditation for NSQHS standards Pharmacy Board - registration req's Medicines and Poisons Reg Branch - WA Poisons Act and Regs TGA -Manufacturing Medicare Australia - PBS claiming |
| What is the purpose of internal audits? | Integrity and ethics, quality, safety and performance Auditing against national standards Exception reporting (e.g. barcode scanning) Anything and anyone Relates back to quality improvement |
| How does NHQSH accreditation relate to pharmacists? | Pharmacists are involved in all aspects: Clinical governance, partnering with consumers, healthcare associated infection, medication safety, comprehensive care, communicating for safety, blood management, recognising/responding to acute deterioration. |
| How are policies and guidelines different? | P: enforceable through management, requires objective KPI's, generally brief and concise, varaition not permitted G: individual treatments into context, st of treatment options, decision pathway, variability allowed dependent on patient factors |
| What is the purpose of mandatory training? | To maintain care standards. Broadly range from basic life support, record keeping, ATSI awareness, emergency response. Different roles will have different requirements. Timeframe can vary from once annually to once every three years. |
| What is credentialing? | Another form of maintaining stnadards. Assessment against a pre-determined standard. Determines if it is safe for the clinician and patient for that person to be performing that task. Professional development also part of credentialing. |
| What areas are managed by corporate governance? | Procurement, financial responsibilities, legal respons, manufacturing standards, ICT infrastructure, risk management |
| What areas are managed by clinical governance? | Medication safety, medication storage, evidence based practice, allergy management, informed patient-centred care, quality improvement |
Created by:
LDM
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