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Clinical Audit for Improvement: Speaker News and Updates

Today’s  conference updated clinical audit managers, leads and clinicians running clinical audit programmes on national and local developments in clinical audit policy and practice. The conference opened with an update on monitoring and improving quality through clinical audit, trust reporting and action planning, national and local developments, and what needs to change in trust for clinical audit.

A key focus of the day was to ensure clinical audit leads can effectively improvement quality and implement changes as a result of clinical audit programmes. Practical case studies focused on developing an effective clinical audit programme and supporting staff to deliver quality through clinical audit, clinical audit board assurance, clinical audit for patient safety with an update on developments in mortality audit and monitoring, learning from the CQC inspections with regard to what the CQC are looking for in terms of clinical audit, reporting clinical audit findings, delivering change as a result of clinical audit findings and demonstrating involvement, reflection and improvement as a result of involvement in national clinical audit at a local level.

Speakers and Presentations from the day include:

Monitoring and improving Quality through Clinical Audit

Mandy Smith Quality Improvement & Development Facilitator 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?

Mandy Smith Full Presentation Click Here 

Mandy discussed the importance of completing the audit cycle and ensuring change occurs. Mandy talked about the importance of clinicians working together on clinical audit and stated "successful clinical audit means completing the cycle - but audit for monitoring allows you to dodge the difficult bits. We must use audit to improve."

The value of junior doctor audit has been questioned but Mandy stated that in her view some of the best audits she has seen have been from junior doctors and these are very important.

Mandy also questioned how you get the right information to the board without drowning them in information. There is more information in the Clinical Audit guide on this. 

Clinical Audit awareness week will take place on 22-30 November this year. Mandy encouraged audit leads to spread the word through celebrating audit, audit tea parties and sharing what you are doing with HQIP. More details can be found here

Mandy announced her retirement at this conference, we would like to take the opportunity to thank you for her contributions to HCUK conferences and wish her well.

HQIP Guides

Mandy Smith Biography:

Mandy works to develop products and resources to encourage and facilitate clinical audit and other quality improvement activities at a local level. She supports regional clinical audit networks and local healthcare providers in the Midlands and North of England.  

National clinical audit for quality and patient outcomes improvement

Cathy Hassell Deputy Director, Quality Programmes, Medical Directorate NHS England

  • developing meaningful and comparable measurements for all major pathways of care for every provider
  • measuring the impact of clinical audit
  • developing better use of clinical audit in commissioning
  • NHS England Update

Cathy discussed the latest developments in NHS England, how NHS England uses national clinical audit, local clinical audit and the patient outcomes programme.

"We want to make sure clinical audit is of the right quality and coverage. We use national clinical audit to inform national policy development, to inform specialist commissioning, for tariff development, to help improve efficiency, to support ccgs to use evidence base, and to assess progress on quality improvement."

Cathy went on to discuss clinical priorities and the role of national clinical audit within them.

Cathy also discussed the clinical outcomes programme, including the publication of consultant level outcomes with the purpose being intelligent transparency with the public and to inform choice and benchmarking.

Cathy stated "We need to be honest about the fact that clinical audit is not always about improvement but can be about quality assurance. This is due to timeliness, accuracy, and relevance. Clinical audit has a function in improvement but sometimes it is about assuring ourselves we are not outliers."

NHS Englands next steps: "The focus is about sustainability. We need to keep up with technology and NHS Digital. We need to align with the strategic aims around information in the NHS. We need look at efficiency and value for money. We also need to look at ways of looking at care pathways across organisation - the care event rather than care setting. This is bigger than clinical audit and needs information to be linked."

Cathy Hassell Biography:

As Head of Clinical Programmes Cathy currently leads NHS England’s National Clinical Audit, Seven Day Hospital Services, and Quality Standards programmes, which all aim to support improvement in the quality of NHS services.

Cathy has previously worked as a commissioner of independent sector services for the NHS at regional level, led the implementation of patient choice policy and was involved in the roll out of clinical information systems in general practice and stroke telemedicine services for users across Yorkshire and the Humber.    

Over the past few years Cathy has been involved in the establishment and design of NHS England as part of the government’s ambition to bring about a more clinically-led, patient-centred commissioning system.”

Developing an effective local quality improvement programme and supporting staff to deliver quality care

Carl Walker Chair National Quality Improvement & Clinical Audit Network (NQICAN) Clinical Audit Manager University Hospitals of Leicester NHS Foundation Trust

  • supporting and enabling clinicians to test changes and sustained improvement
  • how do you measure the effectiveness of your quality improvement programme?
  • how do you identify where patient care activities require immediate improvement? Working with risk registers and assurance
  • our experience

Carl Walker Full Presentation Click Here

Carl discussed the objectives of NQICAN stating “NQICAN works with and provides a (national & regional) voice for staff working in clinical audit and quality improvement in organisations who provide care to health care to NHS patients and social care.”

Carl went on to discuss 3 types of measurements in healthcare – assurance/accountability/judgement, improvement and research stating why each measurement is used.

Carl continued with a look at what is needed for success and sated from Health Quality Quests – Quality improvement for healthcare manual “sustained implementation of quality improvement in healthcare organisations in the USA identified that continuously successful improvement programmes are associated with the presence of the following four dimensions in the organisation – Strategy, Structure and systems, Culture and Technical support.”

Carl Walker Presentation Abstract:

The National Quality Improvement & Clinical Audit Network (NQICAN) aims to provide a (national and regional) voice for staff working in clinical audit and quality improvement in organisations that provide care to health care to NHS patients and social care.

The Berwick Report in 2013 highlighted that "Collaborative learning through safety and quality improvement networks can be extremely effective and should be encouraged across the NHS.  The best networks are those that are owned by their members, who determine priorities for their own learning."

Carl shared his/NQICAN’s experiences as to what works when developing an effective local quality improvement programme and supporting staff to deliver quality care and explain why.

The presentation provided tips/case studies/resources that are available to help create a culture to support and enable clinicians to test changes and make sustained improvements & also how to measure the effectiveness of your quality improvement projects.

Carl Walker Biography:

Carl has worked in clinical audit at University Hospitals of Leicester NHS Trust in various posts since graduating from Coventry University with BSc hons in Stats/Business in the late 90s and has been clinical audit manager at UHL for over 6 years. Carl has been a member of East midlands clinical audit support network (EMCASNet) since 2011 and has been a member of NAGG / NQICAN since 2012. Carl has been to Ethiopia to teach clinical audit & has led on NQICAN EPR clinical audit work and presented at last year’s conference. Carl has recently been elected as NQICAN chair and is enjoying continuing the good work that the group has achieved under outgoing chair Kat Young. Carl is keen for NQICAN to champion the importance of clinical audit and other quality improvement methods & supporting the professionals & clinicians undertaking these projects to help improve patient care.

Addressing co-morbidity in national and local clinical audit: Moving from disease specific audit to pathways

Dr Bob Young Consultant Physician & Diabetologist Salford Royal Foundation NHS Trust Member National Advisory Group on Clinical Audit and Enquiries (NAGCAE)

  • how do we move from disease specific clinical audit to an approach that takes account of co-morbidity and integration of care
  • auditing pathways of care and linking across audits
  • what can Clinical Audit learn from the new Vanguard sites

Future events include:

Hospital Mortality Annual Summit: Mortality Monitoring & Reducing Avoidable Deaths attributable to problems in care
Thursday 20 October 2016 
Hallam Conference Centre, London

Clinical Audit Masterclass
Tuesday 29 November 2016 
Hallam Conference Centre, London

Clinical Audit Masterclass
Friday 3 February 2017 
De Vere West One, London

5 October 2016


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