Using PRIMIS tools to help deliver Quality, Innovation, Productivity and Prevention (QIPP) through clinical audit
Clinical audit can help GPs and practices review and evaluate the quality of their work by providing evidence of professional competence and efforts to improve their clinical practice for the benefit of their patients. Clinical audit need not be complicated; sometimes the most simple of audits prove to be the most effective in terms of the impact on patient care.
There are four simple steps involved when using a PRIMIS audit tool for the purposes of clinical audit:
The first step in the improvement process is deciding which quality improvement tool to use. There are a wide range of validated clinical tools available from PRIMIS. Each topic has been designed to facilitate easy and reliable clinical audit in general practice using CHART.
Ideally, you should select a topic that will have the greatest clinical impact with minimal effort. Your decision should be based upon one (or a combination) of the following factors:
For help with running any of the quality improvement tools see the Help page.
Once you have run a PRIMIS quality improvement tool on your practice clinical system, results can be viewed in CHART instantly. Presentation of the results within CHART supports effective action planning, highlights existing good practice and helps to identify areas for improvement.
It is important that you fully understand the results and what they mean for your practice. All of the clinical tools developed by PRIMIS are accompanied by a full instruction booklet designed to help practices understand their results and identify next steps.
The most important thing to remember when interpreting data is to use common sense and to analyse clinical data in context. It is important to understand the characteristics of your practice population when undertaking audit as certain factors can affect your results.
Always consider whether the conclusions being drawn from the data actually make sense. Do not assume that because the data suggests a link between particular elements that it must be a fact. Further investigation is usually needed to determine why there is a link. This means considering the many aspects that could have affected the data and produced the results you are seeing, for example:
PRIMIS can help you to interpret your practice results and work with you to generate an action plan. Discover more information.
Now you have your results data, you need to take action. Consider holding a practice meeting with key staff so everyone is involved from the start. Involvement of the whole team ensures commitment and that the focus of audit is on improving care for patients rather than the work of any individual. The aim of the meeting is to create a realistic and achievable action plan with specified deadlines to work to and named people allocated to each task.
Alternatively PRIMIS can facilitate a practice action planning meeting for you - email for more information.
Audit is a cyclical process which demonstrates that improvement has been achieved and sustained. This can only be achieved by repeating the audit and reviewing the latest results following implementation of the action plan.
To be truly effective, clinical audit should become part of everyday practice. This may seem a daunting challenge, however, it is possible to embed clinical audit into the day-to-day work of a GP practice.
Topics can be picked that fit in with what you already do on a regular basis. This could include QOF areas, where practice audit can go beyond the requirements of QOF and at the same time meet QOF standards. GPs may run specialised clinics or be the practice lead for specific clinical conditions or procedures. Carrying out audit in these areas will provide evidence of the standards and quality of care delivery.
Practices who audit regularly will continue to improve healthcare outcomes and learn to use scarce NHS resources more efficiently.
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