This document by the Yorkshire & Humber AHSN Improvement Academy provides guidance on using the structured judgement review method for case note review. Structured judgement review aims to look for strengths and weaknesses in the caring process, learn lessons from examples of good care and identify gaps and problems.
Structured judgement review blends opinion-based review methods with a standard format that involves staff:
- making safety and quality judgements over phases of care
- making explicit written comments about care
- scoring care in each phase.
This provides a rich set of information about each case in a form that can also be aggregated to produce knowledge about clinical services and systems of care.
The purpose of the review process is not to point to individuals, but to ask questions about the system in which people work, both when care goes well and when it is unsatisfactory. To do this effectively, the method looks at the whole range of care, including holistic care approaches, the nuances of case management and the outcomes of interventions.