Accountability- knowledge, skills, values and attitudes

As healthcare professionals we hear about ‘accountability’ a lot. But what does it actually mean in the context of this course?

Accountability means that when you are making those judgements about the management of the child (including managing their parent) you have to be able to explain the basis on which they were reached, i.e. provide a rationale.
Professionally, this relates to any aspect of care given to your patients (Dimond ,2004) The diagram above shows the key principles of accountability. Take a look and apply these when you are working through the practice cases within this course and your live consultations.

The table below shows the Six dimensions of Quality in Healthcare (institute of medicine, 2001) and how they translate to paediatric minor illness consultations. Think about what elements of practice would fit with each of the dimensions below.

1. Safe From studies such as the Harvard Medical practice study undertaken in the 1990s (Baker, 2004) there is now emerging evidence that safety develops from the interaction of components in a system. In other words to gain a safe consultation there are a number of elements that need to be present. Some of these include communication, documentation, safety netting, clinical knowledge, knowledge of children, knowledge of safeguarding……

2. Effective It is fundamentally concerned with weighing up the interests of patients and clients in often complex situations, whilst using professional knowledge, judgement and skills, based on evidence, to make a decision.

3. Patient centred Recognizes the intrinsic worth of a person and the environment in which they live (McCormack, 2004). Your care for the parent and child should promote the rights and expectations of the child and parent and treat the child (and the parent) not just the disease.

4. Timely recognising that a child may present at any stage of their illness so safety netting is important

5. Efficient Depends on your practice requirements, e.g. if commencing a medication for child you would need a range of knowledge, such as medicines, allergies, what you are treating, pharmacology and calculations, etc. You would also require knowledge of policies, best practice, standards and procedures.Focussed consultation

6. Equitable Taking into account the mandatory requirements for treating children e.g equality and diversity, FGM, learning disbilities, safeguarding.treat every parent/ child with the same level of respect.

This is like building a jenga tower with the different elements making up a safe tower. Any of these elements missing render the consultation open to poor care.

So bearing this in mind continue through the course and enjoy!