Transcript Document

Connecting BASHH National Audits
to
Local Audit
and
Practitioner Re-certification
Hugo McClean
Secretary BASHH National Audit Group
Summary questions
• What do UK advisory bodies say
about the role of audit in Quality?
• What do UK professional bodies say
about the role of audit in recertification?
• Can the BASHH national audits
provide an important (local) resource?
… will be posted on BASHH website
National advisory bodies
– “the reinvigoration of clinical audit”
– “..increase the impact that clinical audit
has on healthcare quality …
http://www.dh.gov.uk/ab/NCAAG/index.htm
http://www.hqip.org.uk/about-us/
Healthcare Quality
Improvement Partnership
National-Local Clinical Audit
• Seamless links between national and
local audit
• Evidence of participation in audit, and
the results of audit, used for
secondary purposes. ….revalidation of
healthcare professionals
http://www.hqip.org.uk/local-clinical-audit/
UK Professional Bodies:
Royal College of Nursing• Information and
Knowledge 2
Information
collection and
analysis
• Core 4 Service
improvement
• Core 5 Quality
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy
AndGuidance/DH_4090843
UK Professional Bodies:
Clinical audit & revalidation –
GMC
– Revised Framework / Explanatory Note to the Framework
– Derived from Good Medical Practice
Royal College of Physicians
– Specialty-specific Framework
BASHH
– In development
http://www.gmc-uk.org/doctors/licensing/revalidation/index.asp
http://www.rcplondon.ac.uk/clinical-standards/organisation/Pages/Clinical-Audit.aspx
GMC/Specialties
Framework for appraisal and assessment :
• Domain 1 (Knowledge, Skills and Performance )
• Domain 2 (Safety and Quality )
– “Participation in national or other multi-centre
(e.g. regional) and local audit
– “one full audit cycle … within each five-year
revalidation period”
– … with evidence of any practice change
demonstrated by re-audit”
http://www.gmc-uk.org/doctors/licensing/revalidation/gmp_framework.asp
BASHH National Audits
• Annual online audits against
BASHH clinical practice
standards
• National and regional
aggregates
• Comparisons between clinics
in regions, between regions
and against national average
performance
• Regional Audit
Chairs/Groups
• Embrace local audit
National & regional aggregates
The Audit Cycle
Using the BASHH National Audits- 1
• Managed the collection of data for my clinic
for the BASHH 07 Audit on Management of
Chlamydia Infection … processed through
clinical governance
• Produced a data set of performance measures
for our clinic
• Compared our performance against other
clinics in the Region, and against the BASHH
national guideline for chlamydial management.
– only 40% of cases received written information
about chlamydia
– 60% follow-up of cases in clinics …
Using the BASHH National Audits- 2
• Interventions:
– changed from routine follow-up of cases
in clinic to telephone follow-up
– led a process that found our health
advisers/nurses dedicated time for
telephone follow-up of chlamydial cases
– produced a new proforma in our clinic,
including prompts for scheduling followup and providing written information …
Using the BASHH National Audits- 3
• Led re-audit of chlamydia management,
using the same questions from the BASHH
chlamydia audit
• Measured the effect of the interventions
introduced aimed at improving practice and
demonstrated significant improvement:
– … reduced follow-up in clinics from 60% to 20%,
freeing up time in clinics to see more patients
– … increased our overall follow-up rate from 70%
to 85%, by switching to telephone follow-up
– … 60% of cases are now recorded as having
received written information
Development of BASHH
national audits
• Moving towards shorter, higher impact
audits and re-audits
• Based partly on new BASHH standards for
STI services (in development)
• Linked to revalidation/recertification
Summary
• BASHH national audits :
– Embrace local audit
– Connect local audit to regional and national
performance and national guidelines
– Provide individual clinicians with resource for recertification & performance review
• Completed audit cycles needed for physician
relicensure & specialist re-certification
Acknowledgements
• Chris Carne, Chair BASHH National
Audit Group
• Mark FitzGerald, BASHH