Ebook Good medical practice - Professionalism, ethics and law: Part 2
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Ebook Good medical practice - Professionalism, ethics and law: Part 2
MAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2luctant to embrace compulsory continuing medical education ((.MF.) or compulsory recertification of their professional competence. Such reluctance in regard to making this obligation compulsory relates to factors including scepticism that recertification will necessarily improve standards of patient Ebook Good medical practice - Professionalism, ethics and law: Part 2 care or prevent the problems created by incompetent members of the profession; awareness that the medical profession is generally very committed to CEbook Good medical practice - Professionalism, ethics and law: Part 2
ME, and to evaluation of care through clinical research and its dissemination and publication; and, lastly, sensitivity by many doctors to the accountMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2to the need to document maintenance of professional competence in the profession with formal initiatives taken by all the medical colleges. These initiatives, while eschewing examinations, arc designed to reflect the realities of everyday professional life and are consistent with education and learn Ebook Good medical practice - Professionalism, ethics and law: Part 2ing theory, itself still evolving. A small proportion of doctors still resent this perceived bureaucratic intrusion, but the benefits for the medicalEbook Good medical practice - Professionalism, ethics and law: Part 2
profession and rhe community outweigh any additional effort involved in documenting what most doctors already do.Apart from the ethical dimension therMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2 voluntary accreditation of hospitals via a process attesting to the meeting of predetermined standards began when the Australian Council on Healthcare (initially ‘ỉTospital’) Standards (ACIĨS) was established in 1974. The first medical college to introduce mandatory recertification of competence wa Ebook Good medical practice - Professionalism, ethics and law: Part 2s the Royal Australian College of Obstetrics and Gynaecology when it was established in 1978. The federal government has also been interested in thisEbook Good medical practice - Professionalism, ethics and law: Part 2
subject, dating back to an ultimatum, given to the medical profession in 1976 by the federal Minister of Health, thatMaintenance of professional compeMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2or example in Victoria, the Health Professions Registration Act 2005 (which came into force in 2007) gives registration boards the power under section 18(3)(b)(ii) to ask at renewal of registration for evidence of ‘any continuing professional development undertaken during the existing registration p Ebook Good medical practice - Professionalism, ethics and law: Part 2eriod'. The New South Wales Medical Board requires doctors, when applying for renewal of registration, to advise of details of participation in continEbook Good medical practice - Professionalism, ethics and law: Part 2
uing professional development. Similar provisions exist in South Australia.This chapter outlines what the terminology means, describes examples of curMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2xamples of a range of other processes in place for accreditation and outcome evaluation or audit in health care. The chapter focuses primarily on the responsibilities of individual doctors and not on the responsibilities of those who manage hospitals and health-care institutions. Increasingly such i Ebook Good medical practice - Professionalism, ethics and law: Part 2nstitutions arc expected to have in place a system of clinical governance (incorporating safety and quality of care, risk management and performance rEbook Good medical practice - Professionalism, ethics and law: Part 2
eporting); effective clinical governance involves significant input from clinicians 111.12.1THE TERMINOLOGY OF MAINTAINING PROFESSIONAL COMPETENCE1 heMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2, audit, quality assurance, peer review, accreditation, credentialling and granting of clinical privileges, vocational registration, clinical indicators, clinical practice guidelines and recertification, rhe following is a brief explanation of these terms.12.1.1Maintenance of professional standards Ebook Good medical practice - Professionalism, ethics and law: Part 2and continuing professional developmentThis is a process directed at the individual doctor. It presumes that, upon entry into independent clinical praEbook Good medical practice - Professionalism, ethics and law: Part 2
ctice, the doctor’s competence was attested to by the satisfactory completion of an appropriate theoretical and practical training program and the awaMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2 the following activities: ongoing education and training, including continuing medical education (CME), quality assurance, audit, teaching, research, self-directed learning, self-assessment and peer review. With this documentation,186 Good Medical Practice12.1.2Continuing medical educationwhile sel Ebook Good medical practice - Professionalism, ethics and law: Part 2f-explanatory, the term now requires definition since participation in identified CME activities is one of rhe key elements of the ‘recertification’ oEbook Good medical practice - Professionalism, ethics and law: Part 2
f specialists and the maintenance of vocational registration for general practitioners. In most medical college programs, CME includes educational meeMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2 international conferences. Active involvement is preferred to and is rewarded more than passive involvement. Furthermore, educational meetings earn more credits for participants when they are planned to meet participants’ needs, are patient-care focused, encourage discussion and interaction, and ar Ebook Good medical practice - Professionalism, ethics and law: Part 2e to be evaluated upon completion. Self-directed learning and completion of self-assessment programs also form part of CME.12.1.3AuditAudit of treatmeEbook Good medical practice - Professionalism, ethics and law: Part 2
nt outcomes has been practised by surgeons for several decades and data are routinely published in surgical journals. In the initial Royal AustralasiaMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2tation and response to these results’ [2]. Surgical audit constitutes a large component of quality assurance in surgical practice.12.1.4Quality assuranceUlis term is borrowed from the manufacturing industry. For health care, ‘quality of care’ has been defined by the US Institute of Medicine as ‘the Ebook Good medical practice - Professionalism, ethics and law: Part 2degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current proEbook Good medical practice - Professionalism, ethics and law: Part 2
fessional knowledge’ [3]. Quality assurance (QA) programs are mandatory for hospitals seeking accreditation with the ACHS. In their simplest form, theMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2uire resources, they should be targeted at problem areas, common conditions, or conditions that are resource intensive, and where improved results are likely to be achievable. An effective QA program is data-based, focuses on processes and systems (rather than the performance of individuals), record Ebook Good medical practice - Professionalism, ethics and law: Part 2s the QA activities and provides feedback leading to corrective action. As QA programs require unfettered discussion of identified problems, state andEbook Good medical practice - Professionalism, ethics and law: Part 2
federal governments have legislated to provide exemption from Freedom of Information laws and protection from disclosure for civil litigation purposeMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2l boards, civil courts or under Medicare Australia regulations, it is accepted that assessment should be made by professional peers. The term ‘peer review’ has been narrowed in its meaning to refer to the process of auditing the methods and results of clinical interventions by a group of medical pee Ebook Good medical practice - Professionalism, ethics and law: Part 2rs. Peer review has been employed extensively in the USA in relation to the granting and reviewing of hospital privileges and to participation in theEbook Good medical practice - Professionalism, ethics and law: Part 2
US Medicare and Medicaid programs. Peer review is implicit in Australia in many QA programs and in components of medical college recertification progrMAINTENANCE OF PROFESSIONAL COMPETENCENo doctor will deny an ethical obligation to provide competent clinical care to patients, but many have been rel Ebook Good medical practice - Professionalism, ethics and law: Part 2ment to the community and to government that explicit criteria have been met as measured by independent external review. Within accredited hospitals, medical practitioners are not tree to undertake any procedure they choose. This restriction depends mainly on the nature of a doctor’s hospital appoin Ebook Good medical practice - Professionalism, ethics and law: Part 2tment (for example, as neurosurgeon, general surgeon or psychiatrist). However, with the rapid development of new technology, including new invasive pEbook Good medical practice - Professionalism, ethics and law: Part 2
rocedures and surgical techniques, hospitals arc becoming more precise in their appointment processes by requiring that doctors are limited to fieldsGọi ngay
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