ICGP Professional Competence System

How to complete the cycle.

Competence

Does the system measure competence?NOWhat does the system measure?What can be counted.Mostly Attendance not outcome.Except in case of Audit & some of the Internal content

Competence

Measurement of competence is very complexThe Dunning–Kruger effect is a cognitive bias in which "people reach erroneous conclusions and make unfortunate choices but their incompetence robs them of the metacognitive ability to realize it.”“ In the modern world the stupid are cocksure while the intelligent are full of doubt.”Medical Experience -Making the same mistakes with increasing confidence over an impressive number of years

What do GPs need to do

Register www.icgp.iePay the feeYou or someone in the practice must be computer savvyConsider putting some time away each week for the purpose of maintenance

Go to www.icgp.ie

Click the Professional Competence System Link

Review your Personal Details and Update if Information is Incorrect

Enter Additional Details and Click ‘Proceed to Payment’

Click the Add an Item Link

Adding an Item & URL

Adding an Item & Attach a File

Adding an Item & Attach a File

Adding an Item & Attach a File

Searching Accredited Events

Refining Search

All Details Automatically Added to Activity Log

Edit and Delete Options

Calculator for Year and CPD Cycle

Print Option

Audit

Audit

Its not rocket scienceIts not researchIts about comparing to standards A sample can be usedImplementing changeRecounting

Medical Council Requirements component of PCS

Actively engaged in audit Minimum - one audit exercise annually that relates directly to their practice   Minimum one hour per month in audit activity recommendedAudit should focus on the practice of the practitioner, not on processes

Distinguishing Audit from Research

® Research evaluates practice or compares alternative practices, with the purpose of contributing to a body of knowledge. It asks the question “What should we be doing?” It is peer reviewed, intends to publish the findings, can be generalised.

® Audit assumes that standards, guidelines or evidence exists, and asks, “Are we doing what we should be doing?” It is the comparison of current practice against previously agreed standards. Audit aims to influence activity at a local level

Source Research Governance Framework - a users' guide NHS – Leeds

http://www.leeds.ac.uk/medicine/psychiatry/research/govern/menu.htm

What is clinical audit?

“a quality improvement process that seeks to improve the patient care and outcomes through systematic review of care against explicit criteria and the implementation of change…”.

NICE. Principles for Best Practice in Clinical Audit. Oxford, Radcliffe Medical Press, 2002.

Audit improves practice.

Clinical audit can...

Assess how closely local practice resembles recommended practice & Reinforce implementation of evidence-based practice Establish if you are actually doing what you think you are doing Provide assurance about the quality of care & Influence improvements to individual patient care Identify major risk, resource and service development implications

http://www.clinicalgovernance.scot.nhs.uk/section2/audit.asp

Identify StandardMeasure activity

Validate against standardMake appropriate changes

Audit steps

Choose a topicDefine your aims and objectivesChoose guideline, Agree criteria and Set your standardsAgree your method & Collect your dataAnalyse & Interpret dataDetermine what changes are neededMake the changes & Re-audit

Example – ACE inhibitors and renal failure.

Guidelines: NICE Guidelines 2002Criteria to be measured: The criteria selected was in terms of the recommended renal function checks-before starting ACE inhibitor, a week after initiation, on annual basis thereafter and on dose increase.

Example (continued)

Standard(s) set: 100% or patients on ACE inhibitors should have renal function checks-before starting ACE inhibitor, a week after initiation, on annual basis thereafter and on dose increase.

Example (continued)

Data Collection tool:Number of patients in the practice

Number of patients on ACE inhibitors

% who had baseline U&E

% who had U&E checked one week later

% who had U&E checked within following 6 months

% who had U&E checked within following 12 months

% who had annual U&E check

% of type 2 diabetics who had annual U&E check while on ACE inhibitor

The Big Six

Stroke and TIAs Acute Coronary Syndrome &

Secondary Prevention Heart Failure Type 2 Diabetes Asthma COPD

In summary

Ensure you are registeredKeep the points ticking overGet familiar with the websiteStart an audit this monthUse ICGP clinical guidesKeep a record of all practice meetings.