1. Teaching Clinical Governance Miss Claire Young Associate Clinical Tutor Mrs Liz Klein Lead Medical Clinical Educator NCUH

2. Difficult subject matter to teach – Wide ranging – Perceived as “boring” Mortality Review – Common themes – Learning points Keogh Review Background

3. Problem Clinical Governance Elements – Education & Training – Clinical Audit – Clinical Effectiveness – Research & Development – Openness – Risk Management

4. Solution Develop an Interactive Programme – Risk management – Learning lessons

5. Case Notes Individual notes identified Notes rewritten as teaching material All entries and Patient details anonymised Test results and ECGs copied “training case note” files created Library of notes created

6. Training Forum Note Review Training notes analysed Learning points identified

7. Training forum Small groups Allocated set of training notes Critique of notes (entries and care received) Feedback to group Learning points identified by individuals

8. Feedback

9. “Speak to F1s on-call about appropriate senior review, use ABCDE as written in notes, I usually write MEWS score and obs.” “Made aware of common areas where problems can occur – good to be put in the position to review from outside perspective” “Not to use (ii) on drug charts, always be systematic and follow ABCDE approach” “Ensure documentation is extremely thorough, document any changes of drugs in notes and kardex and document in d/c letter so GP can continue care appropriately. “Record keeping, know limitations and escalate the care.” Trainee Learning Points

10. The Future Increase library of notes Introduce to FY1 Aid FY to learn from their and their peers’ mistakes