Audit, projects & the e-portfolio

1. Audit, projects & the e-portfolio

2. What is it? • Audit is a cyclical process of measuring actual practice against standards and then improving practice

3. Working in pairs • Draw the audit cycle • List the types of audit you have conducted in the past

4. The audit cycle

5. What do we audit? • Structure: Physical attributes of health care- surgery building, practice equipment, record, staff • Process: What the GP actually does- practice activity such as prescribing habits, hospital referrals, lab usage • Outcome: Changes in patients current and future health status that can be attributed to antecedent health care- prevention of disease-prevention of premature death-patient satisfaction with care provided

6. Types of audit • Self audit • Peer review/audit • External audit

7. Working in pairs • What potential information/data sources do you have in General Practice which you can use to audit?

8. Potential sources of data • Routine practice data • Medical records • External data (PCT) • Practice activity analysis • Prospective recording of data • Surveys • Interviews • Direct observation

9. 10 top tips • Can you reduce the aim of the audit to a simple question (Aims)? • Can you specify what things you need to measure to be able to answer this question (Objectives)? • Can you identify a recognised ‘gold’ standard? • Is your proposed methodology achievable and feasible within the time constraints and resources you have available to you (Methods)? • Can you analyse and make sense of the results that you expect to obtain? • Have you had a test run with just a few cases to identify any unforeseen problems? • Have you discussed it with a second party with an interest in audit to see if they can identify and solve any flaws or potential problems? • Have you considered what you or your practice will do with the results (Implementing Change)? • Have you considered how, when and by whom the audit cycle will be repeated (Sustaining Improvements)? • Have you uploaded the details of your audit into your e-portfolio?

10. Working in pairs • What are the benefits and risks of being involved with audit?

11. Benefits • May reduce frustration in GP, e.g. by improving procedures in GP • Bring about change • Reducing organisational and clinical error • Improving efficiency and effectiveness • Demonstrating good care • Meeting patients needs and expectations • Stimulating education • Promoting higher standards of community care • Bidding for resources • Securing effective medical defence through risk avoidance • Makes you e-portfolio look great!

12. Costs • Time and effort • Commitment may not be shared equally by different members of the team • A willingness to be inspected • A receptive attitude to constructive criticism and the flexibility to change.

13. The e-portfolio entry • Clear statement of a specific and answerable question • Clearly expressed account of relevance to their own practice/organisation • Brief account of the results and how they feed back to the practice. Personal learning points clearly identified • Definite and specific plans for future practice expressed in terms of personal change and system changes and phrased in terms of knowledge, skills and feelings • Demonstrates ability to express learning needs that are specific, measurable and achievable, and relate to the reflection on the subject of the audit/ project • Realistic and definite plans described

14. Group work – ‘snowballing’ • Discuss two potential audit topics you could tackle in the next two months • Then form up with two other pairs to create six potential audit topics defining the aim, objectives, methodology and required resources • Group feedback to HDR

15. 10 top tips – a reminder • Can you reduce the aim of the audit to a simple question (Aims)? • Can you specify what things you need to measure to be able to answer this question (Objectives)? • Can you identify a recognised ‘gold’ standard? • Is your proposed methodology achievable and feasible within the time constraints and resources you have available to you (Methods)? • Can you analyse and make sense of the results that you expect to obtain? • Have you had a test run with just a few cases to identify any unforeseen problems? • Have you discussed it with a second party with an interest in audit to see if they can identify and solve any flaws or potential problems? • Have you considered what you or your practice will do with the results (Implementing Change)? • Have you considered how, when and by whom the audit cycle will be repeated (Sustaining Improvements)? • Have you uploaded the details of your audit into your e-portfolio?

16. Time for coffee!

17. Projects - Top tips • Can you reduce the aim of the project to a simple question (Aims)? • Is your proposed methodology achievable and feasible within the time constraints and resources you have available to you (Methods)? • Can you assess the value or impact of your project? • Have you had a test run to identify any unforeseen problems? • Have you discussed it with your Trainer? • Have you considered what you or your practice will do with the project once it has been completed? • Have you uploaded the details of your project into your e-portfolio?

18. The e-portfolio entry • Clear statement as to the projects aims • Clearly expressed account of relevance to their own practice/organisation • Brief account of what you learnt by conducting the project • Brief account of the outcome and its implications • Demonstrates ability to express learning needs that are specific, measurable and achievable, and relate to the reflection on the subject of the project

19. Group work – ‘snowballing’ • Discuss two potential project topics you could tackle in the next two months • Then form up with two other pairs to create six potential projects defining the aim, objectives, methodology and required resources • Group feedback to HDR

20. Top tips – a reminder • Can you reduce the aim of the project to a simple question (Aims)? • Is your proposed methodology achievable and feasible within the time constraints and resources you have available to you (Methods)? • Can you assess the value or impact of your project? • Have you had a test run to identify any unforeseen problems? • Have you discussed it with your Trainer? • Have you considered what you or your practice will do with the project once it has been completed? • Have you uploaded the details of your project into your e-portfolio?