Clinical audit Flashcards
1
Q
What is clinical audit
A
- Plays a part in risk management
- Often a tool to identify risks or benchmark a clinical srevice or treatment for a particular condition
- Clinical audit is vital; first and foremost for patient care and safety and additionally for the development and improvement of your professional practice
- Help demonstrate your excellent service and identify areas where you can enable real improvements
2
Q
Definition of audit
A
- The systematic analysis of the quality of health care, including procedures used for the diagnosis and treatment, the use of resources and the resulting ooutcome and quality of life for the patient
- A continuous cycle that involves observing practices, setting standards, compaing practice with standards, implementing improvements and observing new practice to ensure that the improvement is maintained
3
Q
Aims of clinical audit
A
- Clinical audit is a continuous cycle of quality improvement
- Seeks to improve patient care and outcomes through systematic review of care against explicit standards and best practice, and to use any shortfalls in standards of care to enable improvement to be made
- The aim of a clinical aufit is to determine whether a current service or procedure reaches a specific standard
- Information used to inform improvements in care, and then evaluate those changes by re-auditing
4
Q
Why is clinical audit important
A
- Relatively recently that the UK has established ‘clinical audit’ as a key activity for the maintenance and improvement of patient care
- Driver: NHS care failings such as the bristol royal infirmary childrens heart surgery scandal
- Community pharmacis: with an NHS contract, you are required to conduct at least two audits per year
- Hospital pharmacists: are required as part of your practice to conduct or be involved in clinical aufits to contribute to the national priorities for the performance of your trust
- NHS trusts are required to support audit work form central funding
- Primary care audit- to improce quality, safety, cost, effectiveness of prescribing
5
Q
Failed patient care
A
6
Q
Catalyst for change
A
7
Q
Process of audit
A
8
Q
Individual steps for clinical audit
A
- Identify your topic
- Building relationships
- Identifying existing standards
- Define your methodology
- Approval
- Data collection
- Analyse and compare
- Report and make recommendations
- Re-audit
9
Q
Identifying your topic
A
- Focuses on a particular aspect of patient care that is considered a priority for improvement
- Which areas of practice are linked with te most risks
- Align your topic with organisational priorities
- Reasonable timeframe
- Accessible to you
- Resource/support for delivery
10
Q
Building relationships
A
- Will your colleagues and managers support you if you recommend change to your service as a result of your audit
- Consider the other stakeholders in your service: Patients, carers, comminsioners, HCP
- Clinical team- when conducting an audit- the team will have shared sense of responsibility/mutal goal
11
Q
Identifying existing standards
A
- Part of the process of clinical audit is to compare your service to existing standards or criteria
- It is also worth researching whether an audit has previously been conducted in your chosen area
- You may be able to use the same tools and you will be able to compare your results with those collected previously
- Develop your audit criteria from existing standards, if available
- Try to make them (SMART) Specific Measurable Attainable Relavent Time-bound
- If no existing standards => make new guidance
12
Q
Define your methodology
Audit sample
A
- You will need to gather data on a sample of your target population
- Representative sample
- Prospective sample (i.e. as when you see them)
- Retrospective sample (patients who have already been through the service) during a particular time period
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13
Q
Audit tools
A
- Designing a simple but comprehensive data collection tool is essential
- Guidance notes on the audit tool
- Record your data electronically wherever possible. This will save time when it comes to analysis
- You dont need ethic approval to conduct a clinical audit
- No breach of patient confidentiality occur if the use of data is carried out by HCP who already have access to the information intheir role of providing care
14
Q
DATA collection
A
- Piloting your audit is essential.
- Does the data you collected accurately measure your service
- Was any info recorded inconsistently across different cases
- Is the data recorded in a way which allows you to perform analysis
- Was the data easy to identify and collect
- Was the ordering of questions intuitive and dlowing
- was the time take to collect the data acceptable to all involved
- Were the qeustions acceptable to the patient, or did they refuse to participate
15
Q
Data analysis
A
- Accurate recording
- Sufficient to analyse your data for the purposes of the audit
- It’s worth spending time ensuring your data is entered accurately. Try taking a sample of your patient cases- 10% is usually sufficient
- For analysis, have a look back at your reasons for conducting the audit, and the standards or guidelines you are comparing with
16
Q
Report and recommendations
A
- How does your service comply with existing standards
- Are you meeting that approved standards or falling short
- Clear outcomes reporting
- Remember that all audits and research have limitations
- Make sure you include your recommendations for change and improvements
- Include an action plan with your recommendations for change. Suggest timescale, responsibilities and measures of success
- Share your findings and thoughts widely. Your aufit may be suitable to roll out on a regional or national level
- Inform change in practice/guidance
- Did your practice exceed current guidelines
17
Q
ReAudit
A
- The success of your changes and improvement can only be evaluated by a repeat audit of your service
- Use the same and similar audit tools
- Update your report to include the outcomes of your repeat audit
- You can continue to re-audit your services to ensure that they continue to meet the required standards
18
Q
Example of audits
Community pharmacy
A
19
Q
Examples of audit
Hospital
A
20
Q
Examples of audit
Primary care pharmacist audit
A
21
Q
Audit of prescribing of an anti-diabetic drug in primary care
What audit standards can we use
A
- Q- NICE criteria- NG28
22
Q
Audit of prescribing of an anti-diabetic drug in primary care
Is there any evidence to support
A
- A clinical trial data informs NICE- its a national guideline therefore evidence based
23
Q
Audit of prescribing of an anti-diabetic drug in primary care
Define the audit standard
A
- A 100% of patients on a GLP-1 should have a reduction in HbA1c of 1% and at least 3% reduction in weight at 6 months
