status quo of quo vadis? - KCE

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110 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76 ORGANISATIONAL DOMAIN Records and information Records 3 1 point Records 8 1 point Records 9 4 points Records 11 10 points Records 13 2 points Records 15 25 points Records 17 5 points Records 18 8 points Records 19 7 points Records 20 12 points Records 21 1 point Records 22 11 points Information for patients Information 3 1 point Information 4 1 point Information 5 2 points Information 7 1.5 points Indicator The practice has a system for transferring and acting on information about patients seen by other doctors out of hours. There is a designated place for the recording of drug allergies and adverse reactions in the notes and these are clearly recorded. For repeat medicines, an indication for the drug can be identified in the records (for drugs added to the repeat prescription with effect from 1 April 2004). Minimum Standard 80%. The blood pressure of patients aged 45 and over is recorded in the preceding five years for at least 65% of patients. There is a system to alert the out-of-hours service or duty doctor to patients dying at home. The practice has up-to-date clinical summaries in at least 60% of patient records The blood pressure of patients aged 45 and over is recorded in the preceding five years for at least 80% of patients. The practice has up-to-date clinical summaries in at least 80% of patient records. 80% of newly registered patients have had their notes summarised within eight weeks of receipt by the practice. The practice has up-to-date clinical summaries in at least 70% of patient records. Ethnic origin is recorded for 100% of new registrations. The percentage of patients aged over 15 years whose notes record smoking status in the past 27 months, except those who have never smoked where smoking status need be recorded only once (Payment stages 40–90%). Indicator The practice has arrangements for patients to speak to GPs and nurses on the telephone during the working day. If a patient is removed from a practice’s list, the practice provides an explanation of the reasons in writing to the patient and information on how to find a new practice, unless it is perceived that such an action would result in a violent response by the patient. The practice supports smokers in stopping smoking by a strategy which includes providing literature and offering appropriate therapy. Patients are able to access a receptionist via telephone and face to face in the practice, for at least 45 hours over five days, Monday to Friday, except where agreed with the PCO.
KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 111 Education and training Education 1 4 points Education 4 3 points Education 5 3 points Education 6 3 points Education 7 4 points Education 8 5 points Education 9 3 points Education 10 6 points Practice management Management 1 1 point Management 2 1 point Management 3 0.5 points Management 4 1 point Management 5 3 points Management 6 2 points Management 7 3 points Management 8 1 point Management 9 3 points Management 10 2 points Indicator There is a record of all practice-employed clinical staff having attended training/updating in basic life support skills in the preceding 18 months. All new staff receive induction training. There is a record of all practice-employed staff having attended training/updating in basic life support skills in the preceding 36 months. The practice conducts an annual review of patient complaints and suggestions to ascertain general learning points which are shared with the team. The practice has undertaken a minimum of 12 significant event reviews in the past three years which could include: • any death occurring in the practice premises • new cancer diagnoses • deaths where terminal care has taken place at home • any suicides • admissions under the Mental Health Act • child protection cases • medication errors. A significant event occurring when a patient may have been subjected to harm, had the circumstance/ outcome been different. All practice-employed nurses have personal learning plans which have been reviewed at annual appraisal. All practice-employed non-clinical team members have an annual appraisal. The practice has undertaken a minimum of three significant event reviews within the last year. Indicator Individual healthcare professionals have access to information on local procedures relating to child protection. There are clearly defined arrangements for backing up computer data, back-up verification, safe storage of back-up tapes and authorisation for loading programmes where a computer is used. The Hepatitis B status of all doctors and relevant practice employed staff is recorded and immunisation recommended if required in accordance with national guidance. The arrangements for instrument sterilisation comply with national guidelines as applicable to primary care. The practice offers a range of appointment times to patients, which as a minimum should include morning and afternoon appointments five mornings and four afternoons per week, except where agreed with the PCO. Person specifications and job descriptions are produced for all advertised vacancies. The practice has systems in place to ensure regular and appropriate inspection, calibration, maintenance and replacement of equipment, including: • a defined responsible person • clear recording • systematic pre-planned schedules • reporting of faults The practice has a policy to ensure the prevention of fraud and has defined levels of financial responsibility and accountability for staff undertaking financial transactions (accounts, payroll, drawings, payment of invoices, signing cheques, petty cash, pensions, superannuation etc.) The practice has a protocol for the identification of carers and a mechanism for the referral of carers for social services assessment. There is a written procedures manual that includes staff employment policies including equal opportunities, bullying and harassment and sickness absence (including illegal drugs, alcohol and stress), to which staff have access.
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