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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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”

11. 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