Quality is the organising principle of everything we do
Lord Darzi, July 08
Quality is the current watchword of health and social care. With the publication of the Department of Health 'Quality Markers and Measures for End of Life Care' in June 2009 and the launch of the Care Quality Commission in April 2009, quality is high on the agenda.
Prof Mike Richards, National Cancer Director, Department of Health | | | | | | | | | | | | The National Gold Standards Framework Centre has been at the forefront of developing a systematic approach to end of life care to promote high quality 'Gold' standard of care for all people approaching the end of life. GSF is mentioned specifically in many of the quality markers and over 29 markers would be attained using GSF in Primary Care, Care Homes and the GSF ADA Audit. This includes; using the 'GSF Prognostic Indicators Guidance'; holistic systematic assessment; end of life tools such as the Liverpool Integrated Care Pathway; advance care planning using eg Preferred Priorities for Care documentation; alongside careful planning for continuity out of hours. |
Now the time has come to see these as all part of one high quality approach. Together these tools add up to more than their parts. A framework needs all of its components firmly in place to be really strong. The Gold Standard Framework aims to bring all of this together and more.
Measuring quality is difficult especially in such an emotionally charged area. We can measure the processes that are in place (eg numbers of practices having multi-disciplinary team meetings or whether a bereavement protocol is in place for all deaths). Currently the main approaches taken by the GSF team are to look at real patient outcome measures using ADA, the after death analysis audit tool and to monitor staff self assessment of competencies. Further work with patients and carers is planned by the GSF team to look at ways to capture user involvement in this challenging area.
Quality Improvement through the GSF Care Homes Training Programme is now well established and evidence shows a reduction in both hospitalisation and length of stay as well as many patient outcomes. June 2009 saw the launch of GSF Next Stage with a Quality Improvement learning resource for general practice teams. This is a 5 session programme with built in ADA before and after the training. (Each session is 50-60 minutes, designed to fit into a practice team meeting).
Quality Recognition for care homes is well advanced with the Quality Hallmark Award given jointly by the GSF team and Age Concern Help the Aged. 20 quality standards have to be met and a portfolio of good practice is scrutinised prior to the award being confirmed and care homes being invited to join the 'Solid Gold Club'.
The Quality Recognition processes for primary care is currently being developed.
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