The COGPED Completed Cycle Audit
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Transcript of The COGPED Completed Cycle Audit
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The COGPED Completed Cycle Audit
Tim Swanwick
Director of Postgraduate General Practice Education
London Deanery
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what are your issues?
in pairs (5 minutes)
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what are my issues?
really useful assessment very clear marking schedule no one should fail I don’t want to have to advise on so many
resubmissions!
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marking schedule
1. Reason for choice of audit
2. Criterion/criteria chosen
3. Standards set
4. Preparation and Planning
5. Data collection 1
6. Changes to be evaluated
7. Data collection 2
8. Conclusions
Potential for change & relevant to practice
Relevant to audit subject and justifiable e.g. current literature
Target towards a standard with a suitable timetable
Evidence of teamwork and adequate discussion where
appropriate
Results compared against standard
Actual example described
Comparison with Data collection (1)
Summary of main issues learned
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exercise
in threes “I’m going to send this in, what do you think?”
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reason for choice of audit
potential for change & relevant to practice
• potential for change - can do something about problems
• relevant to practice – hospital OK – e.g. emergency admissions
common errors
• over-complicated
• too ambitious
• no potential for change
• irrelevant to practice
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criterion/criteria chosen
relevant to audit subject and justifiable
• relevant – is it about the chosen subject?
• justifiable – is it a suitable thing to measure?
common errors
• no understanding of a criterion
• not “inclusion criteria”
• too many criteria
• nested criteria
• criteria confused with standards
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what is a criterion?
a criterion is a statement of quality a criterion is meaningful and measurable “all” and “should” rule a criterion requires a measurable aspect of care , a
quality marker and a “population”
The last recorded BP of all patients with diabetes should be130/80 or less
All telephone calls into the surgery should be answered within five rings
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examples of criteria (exercise)
In threes, give an example of a criterion in each of the following categories– chronic disease– prescribing– management of acute conditions– practice administration– screening
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standards set
target towards a standard + suitable timeframe evidence that might be used
• NHS or local targets
• guidelines
• expert advice
• focus group
• benchmarking
• practice data on other audits
common errors
• confused with criteria
• not justified
• 100% usually over-zealous
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what is a standard?
a figure, usually a % every criterion must have one must be justified
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preparation & planning
evidence of teamwork and adequate discussion where appropriate
• teamwork is an absolute !!
• reasonable description of process
common errors
• “I did it my way…”
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data collection 1
result compared with standard
• a grid makes life easier common errors
• “simply, too many notes”
• data not related to criteria
• data not compared to standard
• discrepancies unexplained
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changes to be evaluated
actual examples described
• short term and..
• … long term: “what will happen in the practice when I’m gone?”
• group work
• systems, practice procedures etc
common errors
• no changes described at all
• no sustainable changes: “I wrote a letter to all the patients…”
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data collection 2
comparison with data collection 1
• again a clear grid is a big help
• results may be better, worse or the same
0%
10%
20%
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40%
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60%
70%
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90%
Standard 1st Data 2nd Data
Audit results
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data collection 2 (continued)
common errors data 2 not collected in same
way as data 1 only the patients subjected to
short term intervention counted
results not compared comparison not adequately
discussed
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conclusions
summary of main issues learned
• specific points about the audit
• general points about the process
common errors
• rare to fail just this
• inadequate discussion
• unjustified assertions
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results
During the the period 1.4.02-31.3.03 214 GPRs passed SA in London 12 through NPMS (5.6%) 202 through audit 22 of these were resubmissions (c.10%) 2 failed during this period (c.1%)
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referral
there’s no failure, only feedback
the vast majority can be rewritten
“how to do it” guide on deanery web site www.londondeanery.ac.uk
guidance on resubmission (only) from TS if required
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exercise
“my audit’s been referred – help!”
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questions and answers?
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National Project Marking Schedule
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National Project Marking Schedule (NPMS)
Approved by the JCPTGP from April 2000 A project:
– addresses a defined problem– is related to previous work– presents qualitative or quantitative findings– interprets these findings– draws conclusions from the evidence presented
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NPMS
competencies tested:
– the ability to construct a logical argument– the ability to communicate in written English– the ability to plan and sustain activity over time
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NPMS
range of acceptable work includes:– a small research study e.g.questionnaire, notes
review, interview study– a literature review– a case study– a proposal for a new service– a discussion paper
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NPMS marking schedule
six criteria for the project each criterion marked from 0 – 5 a pass will score 18 or more each criterion must score 2 or more
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NPMS marking schedule (continued)
aims/question/problem clearly stated relevant literature cited method appropriate relevant findings presented discussion appropriate conclusions appropriate
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NPMS 2002/3
7% of all registrars April 2002- March 2003
– 126 audits– 87% first and second level passes– 13% referred
all marked by the Yorkshire Deanery
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NPMS - The Future
National Project Marking Schedule to become “National”
Audit may become subsumed into trainer’s report
Marking panels in all deaneries Timescale … 2-3 years ?A role within the MRCGP