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

Connecting BASHH National Audits to

Local Audit and

Practitioner Re-certification

Hugo McCleanSecretary BASHH National Audit

Group

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

– “the reinvigoration of clinical audit”

– “..increase the impact that clinical audit has on healthcare quality …

National advisory bodies

http://www.dh.gov.uk/ab/NCAAG/index.htmhttp://www.hqip.org.uk/about-us/

Healthcare Quality Improvement Partnership

National-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/

UK Professional Bodies: Royal College of Nursing-

• Information and Knowledge 2 Information collection and analysis

• Core 4 Service improvement

• Core 5 Qualityhttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4090843

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.rcplondon.ac.uk/clinical-standards/organisation/Pages/Clinical-Audit.aspx

http://www.gmc-uk.org/doctors/licensing/revalidation/index.asp

GMC/Specialties Framework 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

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

National & regional aggregates

The Audit Cycle

Using the BASHH National Audits- 1

• 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- 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 …

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

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

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

Acknowledgements• Chris Carne, Chair BASHH National

Audit Group• Mark FitzGerald, BASHH