1. Introduction to Clinical Audit What Makes a Good Audit? Institute of Rural Health Care Advancing Quality in Primary Care 10 th March 2011 Presenter : Debbie Davies Primary Care Quality Nurse Co-ordinator

2. What Makes a Good 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

3. 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)

4. What Makes a Good Audit? The audit cycle Select priority topic and set Aim and objectives Criteria agreed and standards set Audit (Data collected) Identify areas for improvement Make necessary changes Re-audit

5. 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 dataA pragmatic approach in terms of time and accessing data Uncomplicated statistical analysisUncomplicated statistical analysis Formulation of an action planFormulation of an action plan Initiating change effectivelyInitiating change effectively

6. What Makes a Good Audit? Stage 1:What makes a good audit topic?

7. 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

8. Stage 2 What 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?

9. Stage 3 What 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?

10. Stage 4 Analysis Do you need complex statistical analysis? Generally no, unlike research, most audits will not require heavy number crunching What Makes a Good Audit?

11. Stage 5 Change 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?

12. In summary What makes a good audit? A suitable topicA suitable topic unambiguous agreed criteria (NICE etc)unambiguous agreed criteria (NICE etc) Audits that are multidisciplinaryAudits 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 throughEnsuring validity and reliability through  rigorous development of standards/criteria  Piloting data collection methods  Provide appropriate data collection training

13. What Makes a Good Audit? Contact Details debbie.davies9@wales.nhs.uk 01495-332313 Primary Care Quality and Information Team