What’s needed for lexical databases? Experiences with Kirrkirr
The situation The requirements The benefits What’s needed to make it work How to move forward.
31
-
Upload
hillary-marybeth-stevenson -
Category
Documents
-
view
215 -
download
0
Transcript of The situation The requirements The benefits What’s needed to make it work How to move forward.
• • • • The situation
The requirements
The benefits• • • •
• • • •
What’s needed to make it work• • • •
How to move forward• • • •
• • • • The situation
The requirements
The benefits• • • •
• • • •
What’s needed to make it work• • • •
How to move forward• • • •
Problems junior doctors face in doing clinical audits
The situation
Limited time
Lack of effective training and information
Inappropriate expectations
Lack of support
Problems NHS trusts face relating to junior doctors’ audits
Clinical audits done by junior doctors are not registered
Last minute requests for help
Inappropriate subjects for clinical audit
No reports provided
Audits are not ‘completed’
• • • • The situation
The requirements
The benefits• • • •
• • • •
What’s needed to make it work• • • •
How to move forward• • • •
The benefits to NHS trusts of junior doctors’ clinical audits
Commissioners’ clinical audit requests
National clinical audits
Clinical audit evidence for Care Quality Commissionregulations and outcomes
Supplement to the workforce to carry out clinical audits
Clinical audit evidence for NHS Litigation Authority RiskManagement Standards
Audits in clinical audit programmes for clinical services orthe Trust
• • • • The situation
The requirements
The benefits• • • •
• • • •
What’s needed to make it work• • • •
How to move forward• • • •
The bases for requirements for junior doctors
Good Doctors, Safer Patients, Department of Health
Good Medical Practice, General Medical Council
The UK Foundation Programme Curriculum, Academy ofMedical Royal Colleges
General Standards for Training, Postgraduate MedicalEducation and Training Board
A Reference Guide for Postgraduate Specialty Trainingin the UK, The Gold Guide, UK Health Departments
Foundation doctors’ requirements
Outcome Demonstrates the knowledge, skills, attitudes and behaviours to use audit results to improve patient care
Knowledge • The audit cycle and relevance• Data sources for audit• Data confidentiality• The audit cycle’s relationship to the
improvement of clinical care
Competences • Describes the audit cycle and recognises how it relates to the improvement of clinical care
• Has participated in an audit project• Makes links explicitly to learning/professional
development portfolios
“Foundation doctors are encouraged to consider their possible career pathways and subsequent specialty training
programmes when choosing … audit projects …”
The UK Foundation Programme Curriculum
“Trainees must regularly be involved in the clinical audit process, including
personally participating in planning, data collection and analysis”
Audit reports are one evidence that Registrars are expected to have in their learning portfolios to demonstrate their
experiences and attainment of skills
General Standards for Training and A Reference Guide for Postgraduate Specialty Training in the UK,The Gold Guide
Registrars’ requirements
Junior doctors’ motivations to carry out clinical audits
Meet training requirements for the current level oftraining
Show interest in and commitment to the workinvolved in the next job in the doctor’s careerprogression
Want to make things better for their patients
• • • • The situation
The requirements
The benefits• • • •
• • • •
What’s needed to make it work• • • •
How to move forward• • • •
What’s needed to make junior doctors’ clinical audits work properly
Getting commitment
Providing training
Arranging support
Communicating arrangements
Selecting subjects
Recognising achievement
Strategy document on clinical audit refers to therole of junior doctors in clinical audit
NHS trust policy on involving junior doctors inclinical audit
Getting commitment
The NHS trust’s policy on involving junior doctors inclinical audit
The training on clinical audit available and how toarrange participation
How to access clinical audit documentation such as aproposal form or a report template
Sources of information about clinical audit
Providing training
Who to contact for information or help
At induction — Distribute a clinical audit information sheet
Content in clinical audit training for Foundation doctors
The clinical audit process
How to —
develop standards to measure the quality or safety ofpatient care
collect and collate data, including data protectionrequirements
analyse problems and find their causes
take action and repeat data collection
design a clinical audit
Content in clinical audit training for Registrars
distinguish among descriptive studies, serviceevaluations, research studies and clinical audits
select an important subject for clinical audit
test the validity of standards used in a clinical audit
develop a data collection protocol
report compliance with measures correctly
carry out peer review of clinical audit findings and adjustcompliance percentages as needed
develop detailed action plans to achieve improvement andmonitor implementation
analyse variation in practice
test the statistical significance of a change in practice
How to —
Other points about training on clinical audit
Emphasise that audit doesn’t stop at data collection— goes all the way to getting evidence of improvement
Have practical training sessions with time for practicalwork in the sessions
Subject training to formal evaluation and take action toimprove its appropriateness and effectiveness as needed
Issue certificates recognising participation in training onclinical audit
Clinical audit manager and staff
Clarify roles of —
Clinical audit leads
Clinical audit committee
Clinical directorate or trust clinical governancecommittees
Clinical and educational supervisors
Clinical directors
Arranging support
Registering clinical audits
Access to patient records or electronic data forclinical audit purposes
Sharing and handing over clinical audits amongFoundation doctors
Sharing clinical audit subjects among Registrars
Communicating arrangements
The Trust’s or a clinical service’s clinical auditprogramme
Any subject based on the Foundation Curriculum’scompetences
Selecting subjects
Rapid-cycle approach
One objective
One standard or a few standards
Short time period for data collection
Analysis of problems
Action taken
Repeat data collection
Presentation or celebration event
Certificates of recognition
Participation in training
Participation in a clinical audit
Completion of a clinical audit
Recognising achievement
Summary of what’s needed for junior doctors
Commitment
Information and training
Support
Clear understanding of arrangements
Appropriate subjects
Recognition of achievements
• • • • The situation
The requirements
The benefits• • • •
• • • •
What’s needed to make it work• • • •
How to move forward• • • •
How to move forward
Assess current arrangements in the NHS trust forinvolving junior doctors in clinical audit
Work with key stakeholders to improvearrangements as needed
Assessing current NHS trust arrangements to support junior doctors’ involvement in clinical audit
Find your strengths to build on
Identify your opportunities for improvement
Possible actions
Could you —
Arrange for a policy to be agreed?
Provide an information sheet for junior doctors onclinical audit?
Communicate arrangements such as registration andaccess to records?
Recommend or assign subjects, in consultation withclinical audit leads?
Provide certificates?
Provide training sessions?
See Guide to Involving Junior Doctors in Clinical Audit at www.hqip.org.uk
