Question 20 Monash Health Practice Exam, June 2016 Quality cycle / patient experience

Question 20 Your Emergency Department has recently performed poorly in a patient satisfaction survey. Topical Quality – don’t formally practice this every day, need to read but once read simple building blocks to use for every question

1. Name the four (4) steps in the quality impovement cycle (4 marks) 1. Plan Plan a change or test of how something works 2. Do Carry out the plan 3. Study Look at the results. What did you find out? 4. Act Decide what actions should be taken to improve

Marking Single words accepted Words or descriptions with same concept accepted Alternative acceptable quality cycles accepted Not accepted 2 steps stating the same thing ie. Two steps in planning

Any quality indicator for emergency medicine accepted 2. Name three (3) quality standards and give one (1) example of how you would measure compliance of each (6 marks) Any quality indicator for emergency medicine accepted Make sure you don’t put the measurement in the left hand column Eg. Time to PCI If can only think of the measure put it in the right then think what it might be an indicator of Eg. Effective/timely delivery of quality healthcare A lot of people just said measurements but not the quality indicator or standard they were measuring – any version of a standard or concept of accepted

Quality indicators / standards Access Waiting times, access block Safety Lost time to work related injuries, body fluid exposures, patient falls Acceptability Patient satisfaction surveys, written complaint rate Effectiveness Admission rate by triage category, time to thrombolysis/PCI, unexplained representation within 48 hours Continuity Provision written health info for sentinel conditions –asthma, wound Efficiency Waiting time by Australasian triage scale

OR National Safety and Quality Health Service Standards (NSQHS) Standard 1: Governance for Safety and Quality in Health Service Organisations Standard 2: Partnering with Consumers Standard 3: Preventing and Controlling Healthcare Associated Infections Standard 4: Medication Safety Standard 5: Patient Identification and Procedure Matching Standard 6: Clinical Handover Standard 7: Blood and Blood Products Standard 8: Preventing and Managing Pressure Injuries Standard 9: Recognising and Responding to Clinical Deterioration in Acute

3. List one (1) initiative that you could take to improve patient experience in your department (1 mark) Needed to be something you could actually do and more specific than “improve communication” Best to choose something simple and easily measured

4. List your four (4) steps in the quality cycle for implementing the above initiative. (4 marks) Take the steps from question 1 and turn them into real life examples – used to show understanding of what the steps actually mean A few people just repeated the words in question 1 – you needed to have specific examples The assess/check step needed to have a specific measure or way to measure eg. Patient satisfaction survey, time to analgesia etc

General tips Stick to your timing A whole blank question doesn’t get any marks Read the stem carefully (tempting to skim read in a time pressured exam) Read each individual question carefully – some will refer to the stem and some will be more general Don’t skip questions to come back to – it’s unlikely you’ll have time Put values ie. BP <100mmHg, rather than “hypotension”

Avoid hedging your bets with additional information – you will only be marked on your first provided answers If you are asked for 4 points and write down 5, have a look and cross the least important one out Use available space and no more – if you find yourself writing in font size 4 in the margins, you are providing too much information Don’t forget the MCQ exam – you need to pass both the pass the exam