Practice Reviews and the Continuous Improvement Continuum 

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We’ve been having discussions with customers recently about practice reviews and how they integrate with existing quality management and continuous improvement activities.

We thought we’d put together an introductory article for anyone interested to learn more about practice reviews.

 

What is a practice review?

Practice reviews are a common occurrence across a range of professional occupations, such as

medical and allied health practitioners, and other human services providers.

For the disability sector, a practice review is a reflective process that examines a provider’s engagement with a participant or group of participants, and improvements that can be made to their experience of the supports and services being delivered by the provider. It often focuses on a particular practice area, cluster of services, and/or practice in particular teams of support workers.

Proactively reviewing and learning from incidents and near misses together with participants helps to continuously improve services, and develop a culture of prevention. In particular, reviews of practice can assist providers in identifying and reducing risks associated with avoidable deaths of NDIS participants.

 

How practice reviews are different

A practice review is not an incident investigation, which forms part of a provider’s incident management system. An investigation is a fact finding process to determine the

root cause of an event, primarily with a view to preventing it happening again.

A practice review is focused on understanding the factors contributing to peoples’ experience of a

service, with a view to learning and improving practice.

For example, following a series of events with negative consequences affecting a number of

participants receiving a particular service, a provider might initiate a practice review to look at why

the poor practice is occurring, and what can be done to improve it.

They are an opportunity for providers to ‘get on the front foot’, with respect to preventing near misses and incidents arising from poor practice, and improving people’s experience of service.

Practice reviews and the continuum of continuous improvement

Practice reviews are one activity in the continuum of continuous improvement activities

providers use. Other activities include:

  • Audits – External
  • Audits – Internal
  • Case reviews
  • Clinical reviews
  • Governance committees
  • Incident reviews
  • Investigations
  • Functional reviews
  • Policy and procedure reviews

A good tip for providers is to develop an annual schedule of continuous improvement activities that is appropriate for your size and scale. A practice review can then be added to your schedule if/when one is triggered. Indicators for triggers are discussed further below.

 

When to do a practice review

There are a number of indicators across 3 domain areas (participants, workers and other) that may trigger a practice review. Examples of each are shown below:

  • Participants – changed health needs, increased number of injuries
  • Workers – changed attendance patterns, staff not completing training
  • Other – increased property damage, high-risk practice areas

You would normally become aware of one or more of these indicators through other continuous

improvement activities described above.

 

Activities of a practice review

The activities of a practice review are centred around how, what and why:

How did this situation/series of events come about?

You will probably have some idea of the ‘how’ before you start a practice review; the indicators discussed above will tell you a lot about “how” events unfolded. You may however need to gather more information about the practice you are looking into before starting the practice review. Familiarise yourself with findings and recommendations from other activities related to the issue or issues prompting the practice review.

Why did this situation/series of events come about?

You may also be aware of some of the ‘why’; however, it is likely further aspects will need to be uncovered during the practice review. Asking the stakeholders involved about ‘why’ something happened is an important component of a practice review as it provides insight into decision making and workplace culture.

What can we do to make things better/improve the situation?

Engaging people in the ‘what’ is critical to gain buy-in to potential change arising from the practice review. It is also essential that participants are encouraged to take part in practice reviews, to reflect on their service experience, and provide ideas on how to improve it. Similarly, frontline workers and managers are well placed to provide insights into how their interactions with participants can be improved.

Centro QMS offers a range of tools to assist with managing your continuous improvement activities. If you’d like to learn more, get in touch with us today.

Information for this article was sourced from the NDIS Commission.

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