Introduction to Clinical Audit

What Makes a Good Audit?

Institute of Rural Health CareAdvancing Quality in Primary Care

10th March 2011

Presenter: Debbie Davies Primary Care Quality Nurse Co-ordinator

What Makes a Good Audit?

Why should you bother doing clinical audit?Why should you bother doing clinical audit?

• Commitment to provide the best possible careCommitment to provide the best possible care

• To support reflective practiceTo support reflective practice

• To improve change methodologyTo improve change methodology

• GMC professional requirement (GMP guidance)GMC professional requirement (GMP guidance)

• NMC professional requirementNMC professional requirement

• Appraisal and RevalidationAppraisal and Revalidation

• Continuing Professional DevelopmentContinuing Professional Development

What Makes a Good Audit?

Clinical Audit is…………

“A quality improvement process that

seeks to improve patient care and

outcomes through systematic review

of care against

explicit criteria and the implementation

of change”

Principles for Best Practice in Clinical Audit (2002, NICE)

What Makes a Good Audit?

The audit cycleSelect priority

topicand set Aim and

objectives Criteria agreed and standards set

Audit (Data collected)

Identify areas for improvement

Make necessary changes

Re-audit

What Makes a Good Audit?

What makes a good audit?What makes a good audit?

• A suitable topicA suitable topic

• Agreed criteria (NICE etc)Agreed criteria (NICE etc)

• Multidisciplinary approachMultidisciplinary approach

• A pragmatic approach in terms of time and accessing A pragmatic approach in terms of time and accessing

datadata

• Uncomplicated statistical analysisUncomplicated statistical analysis

• Formulation of an action planFormulation of an action plan

• Initiating change effectivelyInitiating change effectively

What Makes a Good Audit?

Stage 1:What makes a good audit topic?

What Makes a Good Audit?

Stage 1:What makes a good audit topic?

• Is one with direct importance for patient care

• Good-practice guidance has been issued by a professional or governmental body

• There is significant clinical concern

• Unsatisfactory outcomes have been reported –either incidents or complaints

• There is new research evidence available on the topic

• It is important to you or other members of the team

Stage 2What makes a good literature Review?

• Formulation of an audit question and locating the evidence

Developing criteria and ascribing standards• criteria/standards

What Makes a Good Audit?

Stage 3What makes good data collection

• Retrospective or prospective dataRetrospective or prospective data

• Do not collect unnecessary dataDo not collect unnecessary data

• Time limit and don’t deviate from audit aimTime limit and don’t deviate from audit aim

• reliability and validity

• Using appropriate data collection methodsUsing appropriate data collection methods

What Makes a Good Audit?

Stage 4Analysis

Do you need complex statistical analysis?

Generally no, unlike research, most audits will not require heavy number crunching

What Makes a Good Audit?

Stage 5Change

• Dissemination of audit results-Passive and active feedback

• A consensus is essential in bringing about any changes• Effective management skills• Audit action plan

What Makes a Good Audit?

What Makes a Good Audit?

In summary In summary What makes a good audit?What makes a good audit?

• A suitable topicA suitable topic

• unambiguous agreed criteria (NICE etc)unambiguous agreed criteria (NICE etc)

• Audits that are multidisciplinary Audits that are multidisciplinary

• A pragmatic approach in terms of time and accessing dataA pragmatic approach in terms of time and accessing data

• Uncomplicated statistical analysisUncomplicated statistical analysis

• Formulation of an action planFormulation of an action plan

• Ensuring validity and reliability through Ensuring validity and reliability through rigorous development of standards/criteriarigorous development of standards/criteria

Piloting data collection methodsPiloting data collection methods

Provide appropriate data collection trainingProvide appropriate data collection training

What Makes a Good Audit?

Contact Details

debbie.davies9@wales.nhs.uk 01495-332313

Primary Care Quality and Information Team