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Clinical Audit and the Audit Cycle

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Presentation on theme: "Clinical Audit and the Audit Cycle"— Presentation transcript:

1 Clinical Audit and the Audit Cycle

2 What we are going to cover today
The audit cycle Criteria and standards Structure, process and outcome An audit example Problems with audit How audit fits into ‘Clinical Governance’

3 A definition of audit “The systematic critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient” Working for Patients 1989

4 Effective audit An educational activity Promotes understanding
Resource effective Raises standards Promotes change Source of information Peer led Involves patients

5 The audit cycle Problem or objective identified
Criteria agreed and standards set Re-audit Make necessary changes Audit (Data collected) Identify areas for improvement

6 Another way of expressing the audit cycle
Determine which aspects of current work are to be considered Describe and measure present performance Develop explicit standards Decide what needs to be changed Negotiate change Mobilise resources for change Review and renew the process

7 Criteria and standards
Criteria are those aspects of care that you wish to examine Standards are the pre-stated or implicit levels of success that you wish to achieve

8 Structure, process and outcome
Structure refers to resources you have available (including current knowledge, skills and attitudes) Process refers to what you actually do, e.g. a protocol Outcome refers to the health benefits, cost effectiveness or person satisfaction

9 The great lunch audit Problem Criteria Standards
The service user feels that their meals are cold on arrival from the kitchen because they are plated up in advance The meals will be hot and satisfying to the service users The meals shall be plated up once service users are sat at the table

10 The great lunch audit Methods
A member of the care staff will work with the kitchen staff for two weeks to check that the meals are not plated until the service users are ready to eat. They will then conduct group interviews with the SUs to assess the improvement and produce feedback.

11 Contents of an audit Background Literature review
Criteria and standards Methods or protocol Results Recommendations for change Recommendations for further audit

12 Why audit Useful clinically Encourages teamwork
Improves patient/service user care Financial benefits (sometimes!)

13 Problems with audit Audit and research Statistical verification
Outcome measures and proxies Protocols Closing the loop - introducing change and re-audit

14 Activity Choose an area in your workplace which you would like to change. Using the clinical audit cycle, identify the problem, criteria and standards and the outcome you would like to achieve.

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16 A word about clinical governance
“A framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards by creating an environment in which excellence in clinical care will flourish” A First Class Service 1998

17 ‘Clinical Governance’
Practice accreditation Practice development plans Research Postgraduate medical education Special interest groups Evidence based medicine Audit Personal development plans Dissemination of guidelines

18 ‘Clinical Governance’
Accountability

19 Reference www.glospccag.nhs.uk/userfiles/docstore/pdf/.../auditcycle
Morrell, C and Harvey, G.(2003) The clinical Audit handbook. London. Bailliere Tindell


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