Clinical Audit and Patient Outcomes

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Clinical Audit and Patient Outcomes

• Helen Laing

Jan 06
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National Clinical Audit

• quality improvement process to improve patient
  care and outcomes for patients
• systematic review of care against explicit
  criteria
• aspects of the structure, processes and outcomes
  of care are selected and systematically evaluated
• changes can then be implemented at an individual,
  team, or service level
• further monitoring is used to confirm improvement
  in healthcare delivery

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The National Clinical Audit Programme - Context

• transferred from the Commission for Health
  Improvement in April 04
• 23 audit projects
• commissioned through professional organisations
  Health Social Care Information Centre
• each project c 200-250k per annum total 5.7m
• core team of 4
• other members

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The Importance of the Programme..

• clinical audit and patients outcomes monitoring
  should be vital parts of the cycle of continuous
  improvement in providing healthcare
• as acknowledged by the Bristol Inquiry
• and the DH in National Standards

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Programme Variability

• Not all areas of health care covered
• Total cost - 5.7million
• Time and impact varies some spectacular
  successes other projects not yet leading to
  widespread change even after several years of
  funding
• Limited contracts with agreed end points
• No quality measures
• Were they all clinical audits?
• REVIEW

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Programme review
Priority score
VFM
Time taken
Costs compared
Methods score (99 criteria)
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The future

• New selection system
• More open/public
• New national external group to develop 07/08
  programme
• Contracts clear deliverables and monitor
• 06/07 Programme

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Programme 2006/07
mostly committed
Long list (tsars priorities)
Priorities/VFM (scoring system)
Prioritisation panel
Board and Commission
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Service Improvements
Clinical audit findings high quality,
patient-based, detailed
We publicise best practice and follow up poor
performance
Local clinicians and managers make changes
Patients ask questions
Healthcare improvements
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Developmental standards/ Better Metrics
Core standards
Screening
Healthcare Commission
Investigations
National targets
National reports
Monitoring local action plans
Public portal
Improvement reviews
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Assessment for Improvement

• high quality, clinician-led, patient-based
  information systems are centre stage
• used to corroborate local bodies
  self-assessments against standards
• National Clinical Audit and Patients Outcomes
  Programme is a prime source of such information
• no inherited automatic right to use National
  Programme findings in assessment - consultation

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Annual health check

• Monitor
• re-audit
• Local Presence

• Change
• plans
• invest
• re-configure
• train

• Under-standing
• reflection
• peer review
• sharing ideas

Healthcare Commission corroboration
Multiple data sources, including CAPO
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