Download
1 / 63

Clinical Audit - PowerPoint PPT Presentation


  • 218 Views
  • Uploaded on

Clinical Audit. Jill Warn, Audit & IT Lead Dr John Guy, Clinical Lead. What . do you hope to achieve today? experience have you had of audit?. Today we will look at…. Enhancing your understanding of Audit Getting Audit right for Revalidation The benefits of Audit in Primary Care

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Clinical Audit' - cosima


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Clinical audit

Clinical Audit

Jill Warn, Audit & IT Lead

Dr John Guy, Clinical Lead


What .....

do you hope to achieve today?

experience have you had of audit?


Today we will look at
Today we will look at…...

  • Enhancing your understanding of Audit

  • Getting Audit right for Revalidation

  • The benefits of Audit in Primary Care

  • Implementing change

    Please ask questions / interrupt



What is audit

What is Audit? of the possibilities


Some definitions
Some Definitions of the possibilities

  • Audit is a process used by health professionals to assess, evaluate and improve the care of patients in a systematic way in order to enhance their health and quality of life.

    • OR

  • Deciding what you should be doing, looking at what you are doing, deciding whether you can do it better, implementing any changes and then making sure the changes have worked!


  • What do we audit
    What do we audit? of the possibilities

    • Structure

    • Process

    • Outcome


    Why do an audit
    Why do an audit? of the possibilities

    • Bring about change

    • Best use of resources

    • Improve standards

    • Stimulate education

    • Reduce errors (clinical and organisational)


    Gmc advice
    GMC advice of the possibilities

    all doctors should take part in systematic audit and be familiar with the principles and practice of clinical audit


    It is about
    It is about of the possibilities

    Auditing your own practice!


    What to consider when choosing a subject
    What to consider when choosing a subject. of the possibilities

    Is your topic appropriate?

    Does it reflect the care undertaken by you the practitioner?

    Is it evidence based?


    QOF areas will not be acceptable of the possibilities


    Which topics to choose
    Which topics to choose? of the possibilities

    For principals / static salaried doctors

    For sessional docs


    Principals
    Principals of the possibilities


    Sessional
    Sessional of the possibilities


    When planning an audit
    When Planning an Audit of the possibilities

    Measure care against a set standard or criteria

    Take action to improve care

    Monitor to sustain improvement


    DDIAY of the possibilities


    Consider
    Consider of the possibilities

    • Being a Learning Organisation

      • Look at the skills within the team

      • Empowerment

      • How might this work?


    Audit and revalidation
    Audit and Revalidation of the possibilities

    • At least one full clinical audit cycle during a revalidation period

    • Significant Events Audit

      • A GP’s portfolio is expected to contain an analysis of at least ten significant events over a 5 year period


    Clinical audit1
    Clinical Audit of the possibilities

    • At least one full audit cycle during a revalidation period

      • Initial audit results

      • Change implemented for the GPs’ patients

      • Re-audit – demonstrating improvement by the GP


    The audit cycle
    The Audit Cycle of the possibilities


    What is an effective audit
    What is an Effective Audit? of the possibilities

    An educational activity

    Promotes understanding

    Resource effective

    Raises standards

    Promotes change

    Source of information


    Writing up your audit

    Writing up your Audit of the possibilities


    The great coffee audit

    The great coffee audit of the possibilities

    Found on Google:

    Gloucestershire PCCAG


    The great coffee audit1

    Problem: of the possibilities

    The doctors feel that their coffee isn’t hot enough after slogging through morning surgery

    The great coffee audit


    The great coffee audit2

    Problem: of the possibilities

    Criteria:

    The doctors feel that their coffee isn’t hot enough after slogging through morning surgery

    The coffee shall be hot and satisfying to the hard pressed docs

    The great coffee audit


    The great coffee audit3

    Problem: of the possibilities

    Criteria:

    Standards:

    The doctors feel that their coffee isn’t hot enough after slogging through morning surgery

    The coffee shall be hot and satisfying to the hard pressed docs

    The coffee shall be served at a temperature of 85-90C on 80% of occasions and there will be 90% satisfaction level expressed by the docs

    The great coffee audit


    The great coffee audit4

    Methods: of the possibilities

    The junior receptionist shall check the temperature of the coffee daily for two weeks and circulate a questionnaire to the partners asking them to score a coffee satisfaction level between 1 and 10. The practice manager shall visit Tesco’s and interview the manager about the availability, costs, quality and sell-by dates of the coffee brands available.

    The great coffee audit


    The great coffee audit5

    Review: of the possibilities

    After a rather tense audit team meeting it was found that the coffee temperature fell below 37C on at least 33% of occasions and reached the standard on only 10% of occasions. The doctors scored the coffee at an average 3/10 and two expressed it undrinkable. The practice manager reported the results of her Tesco’s visit.

    The great coffee audit


    The great coffee audit6

    Change: of the possibilities

    It was agreed to replace the aged coffee maker (after agreeing suitable redundancy terms for the senior receptionist) with a shiny new machine from Argos. As an additional ‘quality initiative’, cream cakes would be served after surgery. The coffee contract would be switched from the corner shop to Tesco PLC Trust.

    The great coffee audit


    The great coffee audit7

    Re-audit: of the possibilities

    For a further two weeks it was agreed to measure the coffee temperature and re-circulate the questionnaire. It was gratifying to find 100% correlation with agreed standards with the exception of one partner who didn’t like coffee anyway.

    The great coffee audit


    The great coffee audit8

    Re-audit: of the possibilities

    Future

    Audit:

    For a further two weeks it was agreed to measure the coffee temperature and re-circulate the questionnaire. It was gratifying to find 100% correlation with agreed standards with the exception of one partner who didn’t like coffee anyway.

    Cost implications of standard maintenance

    Cholesterol assays for partners

    The great coffee audit


    KISS of the possibilities


    Writing criteria
    Writing Criteria of the possibilities

    A criterion is a statement of what should be happening.

    Evidence based

    Measurable

    Clear, unambiguous


    Setting the standard
    Setting the Standard of the possibilities

    • A standard is a number

    • Usually quoted as a percentage

    • One for each criterion

    • Where you think you should be

    • Use group discussion, journals and press, financial targets, last year’s results.


    Collecting the data
    Collecting the Data of the possibilities

    • Consistent information

    • Dedicated time for audit

    • Team Approach

    • Sharing of information


    Collecting data
    Collecting Data of the possibilities

    • Be Organised. Collect essential information only.

    • Think of different possible sources of data.


    Comparing the results with the standard
    Comparing the Results with the Standard of the possibilities

    • Straight comparison

    • If the standard is not met, what can be done to improve things?



    Onset of diabetes a
    Onset of diabetes (a) of the possibilities


    Onset of diabetes b
    Onset of diabetes (b) of the possibilities


    Onset of diabetes c
    Onset of diabetes (c) of the possibilities


    Onset of diabetes d
    Onset of diabetes (d) of the possibilities


    Making the changes
    Making the Changes of the possibilities

    • Is this something you have direct control over?

    • Does patient opinion come into this?

    • Who needs educating?

    • Selling your changes to your colleagues

    • How long will the changes need?


    What can we do to improve things
    What can we do to improve things? of the possibilities

    • ‘For every fatal shooting, there were roughly three non-fatal shootings. And, folks, this is unacceptable in America. It's just unacceptable. And we're going to do something about it.’

      George W. Bush


    Have the changes worked
    Have the Changes Worked? of the possibilities

    • Collect a second set of data

    • Allow time for the changes to take effect

    • Have the changes made a difference?

    • Has the target now been reached?

    • Can further changes be put in place?

    • Is this going to be reviewed again in the future?


    Presenting results
    Presenting Results of the possibilities

    • Results must be clear and understandable

    • Present data in a visual way

    • Avoid complex statistical analysis

    • Quote the numbers before the % for less than 50 pieces of data

    • Be tactful with difficult results


    Why do we use graphs
    Why do we use graphs? of the possibilities

    • The number of asthmatic patients attending for annual review varies according to age, with patients in the 16-24 age group least likely to attend.


    Types of graph pie chart
    Types of Graph: Pie Chart of the possibilities

    Percentage of patients discharged from hospital with either complete, incomplete or no discharge letter


    Types of graph bar chart
    Types of Graph: Bar Chart of the possibilities

    Patient who had a Health Check


    Types of graph line chart
    Types of Graph: Line Chart of the possibilities


    Writing it up for revalidation
    Writing it up for revalidation! of the possibilities

    Title

    Reason for choice

    Dates of first and second data collections

    Criteria and standards with justification

    Results of first data collection – reflection

    Summary of discussion and changes agreed


    • Changes implemented of the possibilities

    • Results of second data collection – reflection

    • Quality improvement achieved

    • Reflections

      • Knowledge skills performance

      • Safety and quality

      • Communication partnership teamwork

      • Maintaining trust


    Quality improvement projects
    Quality improvement projects of the possibilities


    Significant event audit
    Significant event audit of the possibilities

    • The audit should be:

      • transparent

      • It should not be confrontational or judgemental

      • It is not an opportunity to name, shame and blame.


    It should be something in which you are involved of the possibilities

    It should be discussed in a meeting

    Changes involve you

    Reports should not identify the patients


    Should include
    Should include of the possibilities

    Title of event

    Date of event

    Date of meeting

    Description of event

    What went well?

    What could have been done differently?


    and of the possibilities

    • Reflections

    • What changes were proposed

      • For me?

      • For the team?

    • What changes were implemented and their effect?


    Topics to pick
    Topics to pick of the possibilities


    Some ideas
    Some ideas of the possibilities

    New cancer diagnoses

    INR >8

    What about sharing across health economy?


    Any questions
    Any questions? of the possibilities


    ad