When you hear ABC in healthcare it’s common for them to immediately think of ABC in medicine but there is a difference. ABC in Medicine is the initial instruction for essential steps used by both medical professionals, first aiders, first responders and everyday individuals when dealing with a patient. In its original form, it stands for Airway, Breathing, and Circulation. The ABC protocol was originally developed as a memory aid for rescuers performing cardiopulmonary resuscitation, and the most widely known use of the initialism is in the care of the unconscious or unresponsive patient, although it is also used as a reminder of the priorities for assessment and treatment of patients in many acute medical and trauma situations, from first-aid to hospital medical treatment. The ABC technique of airway, breathing, and circulation are all vital for life, and each is required, in that order, for the next to be effective. Since its development, the mnemonic has been extended and modified to fit the different areas in which it is used, with different versions changing the meaning of letters such as from the original ‘Circulation’ to ‘Compressions’ or adding other letters such as an optional “D” step for Disability or Defibrillation. However, when we talk about ABC in healthcare, it is a significantly more advanced and very different from the ABC explained above. So What is ABC in Healthcare?
The ABC of healthcare stands for Access, Behaviour, and Clinical Governance.
Access: In a system of universal healthcare that everyone should have equal access to, the founding principle of the NHS should always remain its cornerstone feature. Continuing austerity measures is causing a negative impact on access. However, with the onset of clinical-led commissioning, this is also changing the relationship between doctors and their patients. Doctors and General Practitioners are being forced to act as double agents commissioning services on one hand and keeping costs down while trying to act in the best interests of their patients.
Behaviour: Doctors and other healthcare staff need to understand that the best way to engage with patients is through empathy, understanding, and respect. These qualities are always paramount. While meaning well doctors believe that the Francis report and the proposed criminal liability misses the point that there needs to be a complementary duty on employers and others to listen and protect staff when they do speak out. Doctors believe that disclosing mistakes would increase trust in the profession but this would come at the expense of more defensive practice, increased litigation and a worsening effect on medical regulation.
Clinical Governance: The NHS must strive to improve the quality of services and standards and must also strive to be accountable. There will be new ways of monitoring and measuring quality with three outcome frameworks, CCG outcome indicators and friends and family tests all along with new target cultures aimed at maintaining quality and standards. Related to clinical governance are the many tiers of workforce issues. One of the biggest challenges for the health service is to attract, train and retain the right talent. Investment in training should continue through medical school, for junior doctors, and beyond this to on the job training as well.
A continuous evolution of the ABC in healthcare is needed to resolve its problems. The usual response to each problem has been not to try to solve it, but healthcare organizations and doctors have to start looking for ways to be more proactive and prevent these problems from happening in the first place. And that is what the ABC in Healthcare should be about.