Unlocking the Potential to Make Clinical Audit Data Count

Welcome back to the NQICAN blog after an unplanned winter / spring break. I think the blog is the only thing that has had a break in 2018 as it has been a very busy year so far for NQICAN, clinical audit community and myself.

One factor behind this busy period has been the success of our NQICAN networking & sharing forum which we launched in Sept last year and we have just seen the 700th post from our (nearly) 500 members. This is way ahead of our forecasts for the uptake we had planned so I wanted to thank everyone for your support and involvement. As we’ve said from the start – the forum will only be as good / useful as we make it so its great to hear the positive feedback i’m hearing when attending regional and local events.  We will be opening up our membership of the NNSF shortly to allow other ß colleagues to join from outside our current criteria to increase the knowledge base / power of the forum.

So lets continue to use the forum to help and support each other to produce good quality clinical audit that helps drive improvements to patient care.

Over the last couple of weeks we have seen two very important publications / resources that I wanted to flag to the clinical audit & other QI community.

Firstly this week NHS Improvement published an excellent resource called making data count to support & encourage analysts and decision-makers to work together to ensure the most relevant data is presented in the most effective way. The core method to the guide is SPC or statistical process control. I have been a fan of this since Davis Balestracci introduced it to my trust in the early ’00s – and being a statistician it made perfect sense to plot the dots to assess variation and improvement trends instead of just comparing 2 numbers. But until recently the infrastructure hasn’t been in place for this to be used as often as it should and I’m confident that this resource will make #plotthedots main stream in the NHS for measuring improvement including clinical audit projects. I made a pledge yesterday to arrange some training for clinical audit professionals and audit lead clinicians so we will start planning this at our next NQICAN meeting in June. Well done to Samantha Riley (NHSI) for driving this publication and also setting up a forum for #plotthedots enthusiasts like myself which I recommend joining – just drop Samantha a line & get involved.

The second publication is from RCP  – Unlocking the potential: Supporting doctors to use national clinical audit (NCA) to drive improvement which follows on nicely from a couple of our previous blogs – whose responsibility & making QI core business.

Following our previous correspondence detailed in the later blog with the lead Dr Emma Vaux I was asked to comment on the final draft of this report and I am very pleased to see that it is recommending that we need to change the perception of clinical audit from data collection to ensuring it is used as a tool for continuous improvement particularly with junior doctors. The report also recommends:

• Sufficient training and resources need to be put in place to support quality improvement activity.
• Stronger educational and organisational infrastructure for trainee doctors is vital in promoting the benefits of NCA data, and in supporting doctors to use the data.
• Doctors should be provided with enough mentoring, time and space to be allowed to access and use data to drive improvements in care.
• Developing quality improvement skills in higher specialty trainees would benefit from combining a regional approach to quality improvement education and training, underpinned by local organisational support involving multidisciplinary teams.

I fully support the recommendations and it will be interesting to see how these are implemented – ideally I would have liked to have seen more in the report around the importance of local clinical audit teams and our role to play in the next steps.  We will discuss the report in full at the next NQICAN and keep you posted on anything specific we can do to support this and other changes made to support QI effective in trusts / junior doctors.

So please let us have your thoughts on both of the above publications either in the relevant posts on the NNSF, in the comments section below or via nqican@gmail.com. I think you will agree that both of these documents provide us with a great opportunity to further embed the importance & impact of clinical audit and it being used as a quality improvement tool so lets use it.

I will publish another blog after our NQICAN meeting in June to introduce our annual report and priorities for 18/19 which include details of how our networks will operate now that we are now longer funded by NCAPOP, our plans for clinical audit awareness week (19th Nov 18) and helping support local clinical audits to be integrated into the wider quality improvement agenda.  As always if you fancy writing a blog please let us know.

Lets keep up this momentum and the power of our networks going…

Regards

Carl Walker, NQICAN chair

ß national audit providers, commercial companies with an interest in CA & other QI, Royal colleges, academics, non-NHS healthcare providers and people with an interest in CA & other QI from outside England