It is obvious that organisations must carry out regular reviews of processes, events and outcomes.
It might be easier to manage and understand this if broken down into broader and more familiar headings.

Events and incidents
Reviewing how we coped with specific incidents, complaints, near misses, and significant events forms a good basis for learning and celebrating good practice.

Exploring good practices and developing strategies for improvement are preventative techniques. Examples are conducting a clinical significant event audit; Clinical improvement meetings; and business planning.

Management performance
In most organisations, this is most often measured in terms of financial performance; customer/patient satisfaction; staff satisfaction; and efficient delivery of services.

Staff performance
Regular staff appraisals are a review tool to help staff focus on career development and performance improvement. This also affords the management better intelligence on performance issues at an early stage. Regular job description and competency reviews help refocus objectives as well as strengths and weaknesses.

System performance
Efficiency reviews force a review of processes and their effectiveness. One of the easiest ways of doing this is to talk to staff at the “coal face” who will be able to pinpoint problems and bottlenecks straight away as they deal with them day in day out. Independent audits can also be useful as it is easy to lose objectivity when you are immersed in a job and have got used to doing things a certain way.

Primary Care Networks (PCNs)

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