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Connecting BASHH National Audits to Local Audit and Practitioner Re-certification

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?

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Connecting BASHH National Audits to Local Audit and Practitioner Re-certification

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  1. Connecting BASHH National Audits to Local Audit and Practitioner Re-certification Hugo McClean Secretary BASHH National Audit Group

  2. 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

  3. 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/

  4. Healthcare Quality Improvement PartnershipNational-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/

  5. 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/PublicationsPolicyAndGuidance/DH_4090843

  6. 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

  7. GMC/SpecialtiesFramework 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

  8. 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

  9. National & regional aggregates

  10. The Audit Cycle

  11. 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- 1

  12. 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 …

  13. 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

  14. 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

  15. 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

  16. Acknowledgements • Chris Carne, Chair BASHH National Audit Group • Mark FitzGerald, BASHH

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