Evidence Based Medicine
Clinical Audit / Significant Event Analysis
Clinical Audit
What actually IS audit?
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1. What are we doing?
Here we measure our actual performance e.g. what percentage of our asthmatic children have had a peak flow recorded in the past six months?
2. What should we be doing?
Here we decide what standard of care we should be aiming at. This step usually involves consensus among colleagues and reading recent publications.
3. Comparing 1 and 2.
Here we face up to how far short of our own standards we actually fall. Sometimes we are pleasantly surprised to find that we have reached them.
4. Negotiating change.
At this stage we examine, with other relevant health professionals, the facets of our practice that need to be changed to allow us to get nearer to the standard that we have set.
5. Closing the loop.
This is a vital step. It entails reauditing the results to see whether our changes have been instituted and whether they are working.
WHY AUDIT?
An old Chinese proverb says:
" It is one thing to know what to do, but another to be sure that we are doing it."
1. Audit allows one to see how near one gets to the standards.
2. It shows how our systems and every day PRACTICE let us down.
3. It gives us opportunity to change to allow our efforts to be optimised.
4. Audit puts the control of the quality of our work into our own hands.
Significant Event Analysis
Aims
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Develop an effective and comprehensive means of reviewing critical events.
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System in place to detect recurrent problems and develop cycles of change
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Should be an educational tool, not penalising.
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Demonstrate the value of all types of experience, positive and negative.
Three major components:
- Events that cause positive or negative feelings in the Doctor
- Death audits
- Complaints
Perceived benefits
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Learn lessons
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Improve self reflection
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Demonstrate need for change
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Recognise that it may be systems and not individuals that are the cause of the breakdown of care
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Fulfills the essential tenets of Clinical governance, Good medical practice, Health and Safety.
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Encourages data collection.
Method
You must use a standard proforma for all significant events, an example is shown below.
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News
VTS Spring Term
14th January
- 13th May 2010
Half Term - 18th February
Easter Break 15th April
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Diary Dates:
Annual Dinner 6th May 2010
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Next set of Exam Application Dates
AKT: 9th - 26th March 2010
(For April 2010)
CSA: 26th Feb - 12th March 2010
(for May 2010)
DRCOG: Closing date 1st Aug 2010 (for October 2010)
DCH: Theory+ Practical 14th - 5th July 2010 (for Theory in September and Practical in November 2010).
Last updated 17/02/10