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Clinical Audit and the Audit Cycle. What we are going to cover today. The audit cycle. What we are going to cover today. The audit cycle Criteria and standards. What we are going to cover today. The audit cycle Criteria and standards Structure, process and outcome.
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Clinical Audit and the Audit Cycle Gloucestershire PCCAG
What we are going to cover today • The audit cycle Gloucestershire PCCAG
What we are going to cover today • The audit cycle • Criteria and standards Gloucestershire PCCAG
What we are going to cover today • The audit cycle • Criteria and standards • Structure, process and outcome Gloucestershire PCCAG
What we are going to cover today • The audit cycle • Criteria and standards • Structure, process and outcome • An audit example Gloucestershire PCCAG
What we are going to cover today • The audit cycle • Criteria and standards • Structure, process and outcome • An audit example • Problems with audit Gloucestershire PCCAG
What we are going to cover today • The audit cycle • Criteria and standards • Structure, process and outcome • An audit example • Problems with audit • How audit fits into ‘Clinical Governance’ Gloucestershire PCCAG
A definition of audit “The systematic critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient” Working for Patients 1989 Gloucestershire PCCAG
Reactions to audit • Enthusiasm • Cynicism • Obligation • Doubt • Exhaustion Gloucestershire PCCAG
Types of audit • Managerial Gloucestershire PCCAG
Types of audit • Managerial • Financial Gloucestershire PCCAG
Types of audit • Managerial • Financial • Clinical Gloucestershire PCCAG
Types of audit • Managerial • Financial • Clinical Multi-disciplinary Gloucestershire PCCAG
Types of audit • Managerial • Financial • Clinical Multi-disciplinary Cross boundary Gloucestershire PCCAG
Types of audit • Managerial • Financial • Clinical Multi-disciplinary Cross boundary Cohort based Gloucestershire PCCAG
Types of audit • Managerial • Financial • Clinical Multi-disciplinary Cross boundary Cohort based Comparative Gloucestershire PCCAG
Types of audit • Managerial • Financial • Clinical Multi-disciplinary Cross boundary Cohort based Comparative Significant event based Gloucestershire PCCAG
Effective audit • An educational activity Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding • Resource effective Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding • Resource effective • Raises standards Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding • Resource effective • Raises standards • Promotes change Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding • Resource effective • Raises standards • Promotes change • Source of information Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding • Resource effective • Raises standards • Promotes change • Source of information • Peer led Gloucestershire PCCAG
Effective audit • An educational activity • Promotes understanding • Resource effective • Raises standards • Promotes change • Source of information • Peer led • Involves patients Gloucestershire PCCAG
The audit cycle Problem or objective identified Gloucestershire PCCAG
The audit cycle Problem or objective identified Criteria agreed and standards set Gloucestershire PCCAG
The audit cycle Problem or objective identified Criteria agreed and standards set Audit (Data collected) Gloucestershire PCCAG
The audit cycle Problem or objective identified Criteria agreed and standards set Audit (Data collected) Identify areas for improvement Gloucestershire PCCAG
The audit cycle Problem or objective identified Criteria agreed and standards set Make necessary changes Audit (Data collected) Identify areas for improvement Gloucestershire PCCAG
The audit cycle Problem or objective identified Criteria agreed and standards set Re-audit Make necessary changes Audit (Data collected) Identify areas for improvement Gloucestershire PCCAG
The audit cycle Problem or objective identified Criteria agreed and standards set Re-audit Make necessary changes Audit (Data collected) Identify areas for improvement Gloucestershire PCCAG
Another way of expressing the audit cycle Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered • Describe and measure present performance Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered • Describe and measure present performance • Develop explicit standards Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered • Describe and measure present performance • Develop explicit standards • Decide what needs to be changed Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered • Describe and measure present performance • Develop explicit standards • Decide what needs to be changed • Negotiate change Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered • Describe and measure present performance • Develop explicit standards • Decide what needs to be changed • Negotiate change • Mobilise resources for change Gloucestershire PCCAG
Another way of expressing the audit cycle • Determine which aspects of current work are to be considered • Describe and measure present performance • Develop explicit standards • Decide what needs to be changed • Negotiate change • Mobilise resources for change • Review and renew the process Gloucestershire PCCAG
Criteria and standards Gloucestershire PCCAG
Criteria and standards • Criteria are those aspects of care that you wish to examine Gloucestershire PCCAG
Criteria and standards • Criteria are those aspects of care that you wish to examine • Standards are the pre-stated or implicit levels of success that you wish to achieve Gloucestershire PCCAG
Structure, process and outcome Gloucestershire PCCAG
Structure, process and outcome • Structure refers to resources you have available (including current knowledge, skills and attitudes) Gloucestershire PCCAG
Structure, process and outcome • Structure refers to resources you have available (including current knowledge, skills and attitudes) • Process refers to what you actually do, e.g. a protocol Gloucestershire PCCAG
Structure, process and outcome • Structure refers to resources you have available (including current knowledge, skills and attitudes) • Process refers to what you actually do, e.g. a protocol • Outcome refers to the health benefits, cost effectiveness or patient satisfaction Gloucestershire PCCAG
The great coffee audit Gloucestershire PCCAG
Problem The doctors feel that their coffee isn’t hot enough after slogging through morning surgery The great coffee audit Gloucestershire PCCAG
Problem Criteria The doctors feel that their coffee isn’t hot enough after slogging through morning surgery The coffee shall be hot and satisfying to the hard pressed docs The great coffee audit Gloucestershire PCCAG