DTUK1110

April 26-May 2, 201010 Feature United Kingdom Edition T his article explores the key outcomes and perform- ance indicators expected by CQC in the area of quality and management. Practice manage- ment syst-ems take time to pre- pare and practices need to start to think about this now, as there is no quick fix for poor systems. As CQC looms ahead for NHS and private practices, our aim at Dentabyte is to assist practice managers and owners to meet the new requirements by implement- ing sound management struc- tures that will stand them in good stead when registration becomes mandatory. Defining Quality Quality is divided into three domains: Safety, Clinical Effec- tiveness and the Patient Experi- ence. Practices will be expected to have a quality policy or statement and to submit incident reports to the Care Quality Commission. These would include near misses and health and safety breaches. Measurement, monitoring and maintenance of quality is best done with a regular systematic approach to audit. Quality indicators for safety Dental practices have a duty to ensure that safety and safe- guarding patients and team mem- bers is a priority at all times. (CQC Section 3) Safety is a wide-reaching sub- ject covering general health and safety, infection control and use of radiation in dentistry, all of which should be audited in practice at least annually. The Department of Health have produced a comprehensive infec-tion control audit tool for practices to use covering: • Prevention of blood-borne virus exposure • Decontamination • Environmental design and cleaning • Hand Hygienie • Management of dental devices eg water lines • Personal protective equipment • Waste Disposal This can be quite daunt- ing to use, but help is available from trained personnel to assist with implementation of all safety measures. All practices should also be compliant with the new vetting and barring scheme and local child protection pathways, and a range of other health and safety audits are available from the author as well as many large dental organisations. Quality indicators for clinical effectiveness The aim of dental treatment is to repair the damage caused to teeth and supporting tissues, and to pro- vide personalised care, treatment and support to prevent problems in the future. (CQC Section 2) A quarterly records audit provides a sound tool for assessing if the practice’s clinicians follow a con- sistent reproducible approach to care. The audit should include a range of indicators for each stage of the patient journey including: • Patient details • Patient perceptions • Detailed clinical records • Risk assessment from future disease • Care Plan incorporating self- care, professional prevention and professional treatments • Documented intervals for preventive care • Documented intervals for recalls (oral health review) Well kept records soundly demonstrates if longitudinal health improvements are made at an individual level, and re- flect the quality of the service and management. Other soft- ware based tools are in develop- ment and will be useful for prac- tice population measures of clini- cal effectiveness. Quality Indicators for the pa- tient experience Informing and involving the pa- tient at each stage of the journey through your practice is the key to keeping the patient at the centre of your service and ensuring patient satisfaction, return visits and re- ferral of friends and family. (CQC Section 1). Patients want to feel they made the right decision about visiting the dentist. As it is reasonable to expect a high standard of techni- cal skill when visiting any pro- fessional, their experience and satisfaction level is likely to be determined by their emotional ex- perience on three levels: Did they like you? Did they trust you? Were they impressed by the service you provided? It is possible to capture the patient experience in four easy ways: 1. The satisfaction questionnaire At the end of a course of treatment ask the patient at least two key questions: • How satisfied are you with the care you received? • Would you recommend our service to friends & family? A high positive response rate (>90 per cent) to these questions indicates a good quality service and should be the whole team’s goal at all times. 2. Comments and Compliments Start to capture comments and compliments via your website, by email or in a simple book at reception, and then make a point to congratulate indiv- idual team members who have been praised for attention to de- tail by a patient, and to pull up and TRAIN those who did not im- press. Staff attitude is the single most important factor in wheth- er or not patients come back or recommend your practice, and feedback is evidence of how high the quality of your service is per- ceived to be. 3. Complaints Handling Practices are expected to comply with GDC guidelines and dem- onstrate attendance at core CPD courses in complaints handling. Successful complaints resolution is often less about the incident that upset the patient and more about the way in which their con- cerns were addressed. Team skills need to be developed in listening, responding, acting and improving to prevent future problems, and this can only be done with dedi- cated time and training over a pe- riod of time. 4. Focus groups Set aside time to invite patients to a meeting and find out what they want! The customer is the best judge of what he or she wants! Timely reorganisation of man- agement structures in coming months will ensure that you ach- ieve hassle-free CQC registration in 2011. DT CQC - the three m’s Relevant CQC Regulations The following regulations are relevant to this section: Regulation 8: Assessing and monitoring the quality of service provision Do you identify, monitor and manage risks to people who use, work in or visit your service? Do you seek professional advice in areas where your knowledge is deficient? Regulation 17: Complaints Do your patients know how to compliment or complain about your service? Do you have systems in place to listen, respond and learn from complaints? Regulation 25: Statement of purpose Do you have a statement of purpose and quality assurance that you can give to the CQC? Now is the time to look at the three m’s: measure, monitor and maintain says Seema Sharma