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Clinical Audit for Improvement Summit Birmingham 2017

The Clinical Audit for Improvement Summit Birmingham 2017 supported by Healthcare Quality Improvement Partnership (HQIP) and the National Quality Improvement and Clinical Audit Network (NQICAN) brought together clinicians and managers leading local Clinical Audit for Improvement to set out the major developments, promote innovative areas of clinical audit, and debate the key challenges affecting you and your clinical audit practice.

This summit focused on clinical audit for improvement with a particular focus on the development of effective local clinical audit leading to audit recommendations that change practice and improve patient care. 

Stuart Metcalfe Member National Quality Improvement & Clinical Audit Network (NQICAN) opened the summit with an introduction to the day, followed by an in-depth presentation from Professor Danny Keenan Medical Director Healthcare Quality Improvement Partnership (HQIP) on Monitoring and Improving Quality through Clinical Audit.

Speakers, News and updates:

Monitoring and improving Quality through Clinical Audit

Professor Danny Keenan, Medical Director, Healthcare Quality Improvement Partnership (HQIP)

  • monitoring and improving quality through clinical audit
  • trust reporting and action planning
  • national and local developments
  • clinical audit in Trusts: what needs to change?


In terms of Clinical Audit Danny said “Quality Assurance is a given, the second bit that should fall out of it is Quality Improvement”

Full PowerPoint Presentation

Applying an ethical Framework to the practice of Clinical Audit

Krishna Nair, Head of Assurance & Clinical Effectiveness, Clinical Effectiveness - Director of Operations & Governance, Bradford Teaching Hospitals NHS Foundation Trust

  • is it really a clinical audit?
  • caldicott principles, confidentiality, security, consent and access to information
  • engaging patients and carers
  • using clinical information systems and patient’s case notes
  • sponsorships and prime focus of the audit
  • do you need an ethical approval to publish the audit results?
     

Full PowerPoint Presentation

Delivering sustainable change through a new audit system
Suzanne Henderson 
Project Developer Clinical Audit & Effectiveness Lancashire Teaching Hospitals NHS Foundation Trust

Pre-Conference Abstract

Lancashire Teaching Hospitals NHS Foundation Trust share their story so far, how they came to be involved in the design of a new Clinical Audit and Improvement system, the roll out and the lessons learnt along the way.

Coming from a culture of clinical audit being hidden in the background with little or no transparency of audit activity, the monitoring of planned activities was a laborious task for the team and often resulted in a duplication of work efforts to try and manage a vast Trust wide clinical audit programme. With a strong drive for increased visibility the Trust clinical audit activities are now in a ‘fishbowl’ and the process has become accessible with outcomes visible and real-time robust data now available to all Trust personnel. 

The presentation will take you through the journey so far, how they now need to change and adapt to new processes, how they went live with the Ward Audit element during the recent cyber-attack and how they hope to embed a rigorous new mortality and morbidity review process.  

Full PowerPoint Presentation

Implementing change based on local or national clinical audit findings
Nancy Dixon 
Healthcare Quality Quest 

Pre-Conference Abstract

Many healthcare organizations don’t have an agreed process for interpreting, analysing and acting on clinical audit findings, from either local or national clinical audits. A typical approach has been to leave this aspect of working on clinical audits to clinical groups carrying out a local clinical audit or participating in a national clinical audit. The traditional clinical audit ‘cycle’ called for an action plan to be established when an audit showed the need for improvement; however, in reality, clinical groups on their own can’t always make the changes needed to achieve improvements indicated as needed by clinical audit findings. They can need the support of management and/or other clinicians, departments, services or organizations. 

The evidence base on clinical audit is mixed: The Cochrane review on audit and feedback concludes that ‘the effect of audit and feedback on professional behaviour and patient outcomes ranges from little to no effect to substantial effect.… The effect may be influenced by the type of behaviour it is targeting’.1 Published accounts of acting on local clinical audits show relatively low levels of actions identified as needed actually being implemented and repeat data collection demonstrating improvements in patient care.2–4 On the other hand, some national clinical audits show that changes in practice that benefit patients have been implemented steadily.5 When there is success in implementing changes based on clinical audit findings, it is important to be aware of the influences and drivers that facilitated the changes. 

The challenges in implementing changes in clinical practice are recognized in a new healthcare discipline called implementation science.6 This new discipline studies the processes and methods for getting evidence-based practice into everyday clinical practice. It involves finding out which processes and methods work best under what circumstances to achieve effective and sustained implementation of changes needed for improvement. Implementation science takes account of human factors research that recognizes that people in a workplace can lose concentration on a task they perform on autopilot or can make mistakes in carrying out a task that requires planning and problem-solving.7

A model for working through achieving improvement
A model — I–M–P–R–O–V–E–S — for working through implementing change to achieve improvement follows the stages in the box.8

Full PowerPoint Presentation

Future events of interest:

Clinical Audit Masterclass
Monday 27 November 2017 
De Vere West One Conference Centre, London

Clinical Audit for Improvement in Mental Health
Friday 9 February 2018 
De Vere West One Conference Centre, London

Clinical Audit Summit 2018: Clinical Audit for Improvement
Monday 5 March 2018 
De Vere West One Conference Centre, London


19 October 2017

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