training and educating the clinical team in effective clinical audit practice gaynor smith dr...
TRANSCRIPT
![Page 1: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/1.jpg)
Training and educating the Training and educating the clinical team in effective clinical team in effective
clinical audit practiceclinical audit practice
Gaynor SmithGaynor Smith
Dr Anthony ChoulesDr Anthony Choules
Burton Hospitals NHS Foundation TrustBurton Hospitals NHS Foundation Trust
![Page 2: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/2.jpg)
If something’s worth doing…
• Developing a clinical audit training programme for the clinical team
• Empowering junior doctors to take an active interest in clinical audit and coordinating activity into an integrated audit programme
• Developing a directorate clinical audit programme in practice
![Page 3: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/3.jpg)
Burton NHS Foundation Trust
Junior Doctor Patient Safety ForumS Wren, D Clutton, G Dimitropoulos
What’s this then?
It’s a collaboration between the patient safety lead, audit department, clinical education team and junior doctors, we meet once a month though we get support throughout
Why?Because too often we become bogged down with repetitive tasks and don‘t see the bigger picture!
It’s brilliant, we’ve covered some really important topics already like venous thromboembolism prophylaxis, oxygen therapy and IV cannula care. We’ve had talks from airline pilots as well as consultants and we actually feel like we make a difference!
Sounds great! I’ll definitely come along, I think every hospital should have a group like this!
What do you do there?
Special thanks to Dr Choules, Dr Vickers & Ruth Turner, medical photography
![Page 4: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/4.jpg)
![Page 5: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/5.jpg)
Why do QA projects ?
• Trusts need quality improvement/audit projects to be done
–To ensure patient safety
–To improve patient care
–To satisfy monitoring processes
![Page 6: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/6.jpg)
Why do QA projects ?• Junior doctors are required to do quality improvement
projects– To learn how important they are– To pass their training– To show leadership skills
• But:– They rotate frequently– They don’t always understand what they are looking
at– The are not always well placed to lead change
![Page 7: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/7.jpg)
The Plan• Meaningful audits
– Trust wide– Large scale– Longer timescale
• Enthusiastic supervisors• Good logistic support• An opportunity to implement change and improve
patient care• Fulfilling requirements of Trust and trainee doctors
![Page 8: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/8.jpg)
Topics
• Communication of DNAR
• Communication of deceased patients
• VTE prophylaxis
• Handovers
• Documentation
• Consultant First review
• Self harm in Emergency Department
• Consent
![Page 9: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/9.jpg)
Timeline• Aug/Sept: Assign topics/groups
Introduction to audit
• Sept/Oct: Meet supervisor, plan and obtain approval
• Oct/Nov: Gather data and process
• Dec: Clinical Audit Showcase
– Presentation
– Plans
– Prizes
![Page 10: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/10.jpg)
Timeline
• Jan/Feb/Mar: Implement changes
• Apr: Re-audit
• May: Clinical Audit Showcase
–2nd Presentation
–Prizes
![Page 11: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/11.jpg)
Results• High standard of audits• Feedback demonstrated the effectiveness of
the training and understanding of the clinical audit process
• Some changes were made…• Good publicity (Inside and outside the Trust)
• eportfolio sign-off/publications• Leadership skills
![Page 12: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/12.jpg)
Results
• Handover audit - Standardized handover order of proceedings - Implementing poster in handover room
• Consultant First Review - PTWR proforma to become part of a generic notes – better recording of EDD and diagnosis, VTE prophylaxis etc…
![Page 13: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/13.jpg)
Poster for the handover room
![Page 14: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/14.jpg)
PTWR proforma
![Page 15: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/15.jpg)
PTWR proforma cont
![Page 16: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/16.jpg)
![Page 17: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/17.jpg)
“They have helped to engage us, as junior doctors, in the audit
process of the trust and, therefore, instilled in us the
skills and enthusiasm to play an active role in quality
improvement projects in the future.”
![Page 18: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/18.jpg)
Publicity• Joint Foundation Programme Sharing
Event
• The National Association of Clinical Tutors (NACT)
• Clinical Audit Support Centre winners!
• NHS local website
• International presentations
![Page 19: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/19.jpg)
Our poster for the FP
shared event
![Page 20: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/20.jpg)
![Page 21: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/21.jpg)
Publicity• www.learning.nhslocal.nhs.uk
/best-practice/medicine/programme-improve-audits-junior-doctors
![Page 22: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/22.jpg)
Taking things forward• Smaller groups
• Access to eportfolio
• FY2’s
• New topics
• More consultant supervisors
• Wider interest across the Trust
![Page 23: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/23.jpg)
Workbooks
Just one workbook –
As a tool
![Page 24: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/24.jpg)
New Topics for 2012-13
• Surgical Handover
• IV vs Oral drugs
• Catheters and incidences of UTI
• Frequency of common pathology blood tests
• Urgent Cancer referrals
• Documentation
• Oxygen prescribing
• Re-Admissons
• Use of Gentamicin
![Page 25: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/25.jpg)
![Page 26: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/26.jpg)
Key benefits
• Trainees learnt leadership skills
• Consultants got a willing workforce
• Rekindled enthusiasm for audit/QA
• Developed relationship with Trust chairman/NEDs/board
• Junior staff felt valued
![Page 27: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/27.jpg)
Key Messages
• A Trust wide, collaborative approach allows focus on more meaningful audits and better opportunity for re-audit
• Generates enthusiasm across the Trust• Enhanced experience for juniors• Training junior doctors properly in audit
is an investment for the future
![Page 28: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/28.jpg)
![Page 29: Training and educating the clinical team in effective clinical audit practice Gaynor Smith Dr Anthony Choules Burton Hospitals NHS Foundation Trust](https://reader033.vdocument.in/reader033/viewer/2022051401/56649e055503460f94af1e5a/html5/thumbnails/29.jpg)
What’s next?More great quality Audits/Quality
improvement projects
Clinical Audit Department
Burton Hospitals NHS Foundation Trust
Postgraduate Clinical Tutor
Burton Hospitals NHS Foundation Trust