Connecting BASHH National Audits to
Local Audit and
Practitioner Re-certification
Hugo McCleanSecretary 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 re-certification?
• Can the BASHH national audits provide an important (local) resource? … will be posted on BASHH website
– “the reinvigoration of clinical audit”
– “..increase the impact that clinical audit has on healthcare quality …
National advisory bodies
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 Qualityhttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/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.rcplondon.ac.uk/clinical-standards/organisation/Pages/Clinical-Audit.aspx
http://www.gmc-uk.org/doctors/licensing/revalidation/index.asp
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 follow-up 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
re-certification & performance review
• Completed audit cycles needed for physician relicensure & specialist re-certification
Acknowledgements
• Chris Carne, Chair BASHH National Audit Group
• Mark FitzGerald, BASHH
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