Our Faculty of Medical Consultants MBA / MSc Medical Leadership, have published their Quality Improvement projects in one of two books: Medical Leadership a Toolkit for Service Development and System Transformation (2019) (Editors: Aylott, Perring, Chapman and Nassef) and Why Hospitals Fail, (2017) (Editors, Godbole, Burke and Aylott). Faculty members will provide senior level mentorship and experience for your own personal learning and development in the area of clinical audit and quality improvement.
Clinical audit is usually the first step towards undertaking a Quality Improvement project. We will guide you to move from the design of a Clinical Audit (which is Quality Assurance) to progressing to Quality Improvement, completing your work to the standard required for publication. We will explore with you ways to disseminate and share your findings to improve healthcare and make a difference to patients in your care.
Our courses help doctors to gain a high level of critical thinking skills and greater awareness of themselves by:
• Using best practice and the most contemporary knowledge to design clinical audit and quality improvement
• Utilising a wide range of data collection tools to collect reliable and valid data
• Identifying the most appropriate medical leadership skills to instil confidence in the clinical audit and the quality improvement process
• Enabling doctors to progress from clinical audit to quality improvement with the use of quality improvement methods and time series data collection
• Prepare a report for publication using a quality improvement reporting guideline
This one-day course focuses on the core skills required to undertake clinical audit (as a mechanism of Quality Assurance) and to progress the clinical audit into a quality improvement project. There is so much more to clinical audit than a 5 stage audit cycle and this course provides you with the most up to date knowledge required to do both clinical Audit and Quality Improvement.
Clinical audit is part of a Quality Assurance strategy to benchmark performance against an agreed standard or quality criteria (NHS England, 2018). There are many skills required to plan and design a clinical audit and these include: knowing which quality criteria to benchmark clinical practice against; should you audit against the whole or part of the standard? Should the audit criteria be benchmarked against international or country specific standards and how will you defend your selection of the criteria? How will you choose your sample? How will you explain that your audit sample is representative? These and many more questions will be explored in this one-day Clinical Audit and Quality Improvement workshop day. The second part of the day (in the afternoon) we will examine Quality Improvement and the different theoretical models and frameworks used in this area. Our workshop day will provide you with presentations from doctors who are currently undertaking Quality Improvement projects or who have undertaken them in the past and will share their learning from their projects and show how to avoid barriers and pitfalls and to build a successful career changing quality improvement project.
“Teaching on audit was very helpful for progression. Starting with persona, Demings principle, change management, Quality Improvement, Fishbone analysis and Stakeholder analysis …. Every teaching session was helpful for my audit progression”
“Process Mapping was the best tool that I learnt, because from the start I was unable to perform my audit through a standard PDSA cycle, but the process mapping helped me work through the PDSA cycle in an easier way”
“I was unaware of audit before this session and it has helped me realise where our Department needs to improve and this is a way to quantify how far we need to go”
“It was a great session, although it was our first attempt to audit, we understand that audit and Quality Improvement are very important for the overall improvement of healthcare”
• Critically review and differentiate the process for clinical audit and quality improvement
• Critically review the advantages and limitations of data used for clinical audit and quality improvement projects
• Evaluate the measurement of performance for clinical audit and quality improvement
• Review the 9 approaches / methods of quality improvement, identifying when and how to best use these approaches and identify current limitations
• Review the reporting guideline for Quality Improvement publication
9.30 – Introduction, the role of Clinical Audit, National Clinical Audit and standardised requirements for revalidation and GMC registration
We begin the day explaining the emergence of Clinical Audit as a tool to Quality Assure healthcare services and how it is used to work out how good we are delivering these services. An exploration of the national and local clinical audits to identify their impact on improving services to patients will be explored.
10.00 –Clinical Audit v Quality Improvement – which one to use and Why?
Clinical audit is undertaken using retrospective data, using a 5-point audit cycle, whereas Quality Improvement is undertaken as a prospective study, using time series data to identify if a change has resulted in an improvement. This session shows how to use clinical audit as a baseline and a rationale for Quality Improvement projects and explores the limitations of both clinical audit and quality improvement to create long term sustainable change.
10.30 –Clinical Governance, audit registration, Data protection
Undertaking a stakeholder analysis to know who to involve in the clinical audit – what are the governance requirements and how best to follow the audit cycle. Useful tools to help the Clinical Audit process including PDSA and Fishbone analysis.
11.15 – Break
11.30 – Selecting a sample for the audit in accordance with best Practice guidance
The rationale behind the size and selection method should be documented. Where data is extracted from electronic records, the data extraction process should be tested to ensure the correct data source is being used and the correct sample and data are being extracted.
12.00 – Limitations of Audit and Quality Improvement – natural Cause Variation
Audit data is collected at two random points in time, and it is unclear if these time points represent natural cause variation or if unwarranted variation is occurring. Quality Improvement projects require Statistical process Control to measure if a change has resulted in an improvement. This session will introduce you to data used for audit and data used for Quality Improvement.
13.30 Quality Improvement Tools, Methods, Techniques and Approaches (working with real time projects, e.g SEPSIS)*
Quality Improvement is “the improvement in patient outcomes, System Performance and professional development that results from a combined, Multi-disciplinary approach in how change is delivered” (Batalden et al., 2007). This session draws upon real time Case Studies applying the core elements of Quality Improvement tools and techniques. In addition, delegates are provided with an opportunity to “Process Map” as a way of communicating their own area of focus for Quality Improvement.
1500– Plan, Do, Study, Act for Quality Improvement
The Model for Healthcare Improvement – evaluating data in each PDSA cycle, Run charts, Control charts and Statistical Process Control (working with real time projects, e.g. SEPSIS)*
1600 – Evaluation and Action Planning
We provide you with support to consider an action plan to help make a difference to your own clinical audit and quality improvement journey