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.htm

http://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