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SPVS Roadshows 2005

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10.30 Interpreting and sharing data Dr. Dave Brodbelt. 11.00 Tea ... Clinical Audit is a quality improvement process in clinical practice that seeks ... – PowerPoint PPT presentation

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Title: SPVS Roadshows 2005


1
SPVS Roadshows 2005
  • Using clinical audit to optimise the provision of
    veterinary services

2
SPVS Roadshows 2005
  • Timetable
  • 9.30 Introduction to clinical auditing in
    general practice Bradley Viner
  • 10.00 Evidence based medicine Dr Peter
    Cockcroft
  • 10.30 Interpreting and sharing data Dr. Dave
    Brodbelt
  • 11.00 Tea
  • 11.30 Monitoring standards of performance in
    medical primary care Dr Chris Jenner
  • 12.00 The role of the VN in clinical audit Lisa
    Bluett VN
  • 12.30 Introduction to workshop
  • 12.45 Lunch
  • 13.45 Workshop on the application of clinical
    auditing
  • 15.00 Workshop presentations
  • 16.15 Plenary session questions discussion and
    summary
  • 17.00 End

3
SPVS Roadshows 2005
  • Introduction to clinical audit
  • Bradley Viner BVetMed MSc(VetGP) MRCVS

4
(No Transcript)
5
Background
  • London graduate 1978
  • Own small animal practice since 1979
  • MSc (VetGP) as part of SPVS group
  • DProf with Middx Uni into clinical audit
  • Facilitating MSc group
  • www.vetgp.co.uk

6
Clinical audit - what is it?
  • Clinical Audit is a quality improvement process
    in clinical practice that seeks to establish
    protocols for dealing with particular problems,
    based on documented evidence when it is
    available, monitoring the effectiveness of these
    protocols once they have been put into effect,
    and modifying them as appropriate. It should be
    an ongoing upwards spiral of appraisal and
    improvement. (Viner,2003)

7
Clinical audit medical practice
  • National Institute for Clinical Excellence
  • Principles for Best Practice in Clinical Audit
  • www.nice.org.uk
  • Healthcare Commission
  • www.chai.org.uk

8
Clinical audit vet practice
  • Veterinary Institute
  • for
  • Clinical Excellence

VICE
V.I.C.E.
9
THE CLINICAL AUDIT CYCLE
10
Kolbs learning cycle (reflective practice)
11
Clinical audit- why bother?
  • Bring about change
  • Assure our clients
  • Promote our services
  • Assure our employers
  • Practice standards
  • Professional satisfaction

12
Clinical audit- obstacles
  • Inertia
  • Demands on time
  • Cost
  • Professional freedom
  • Skills

13
Stages in the audit cycle
  • Preparation
  • Establish protocols
  • Selection of criteria
  • Measure performance
  • Review and modify
  • Repeat

14
Preparation
  • Area to audit
  • Define the problem
  • Stakeholders
  • Audit team
  • Resource requirements

15
Stages in the audit cycle
  • Preparation
  • Establish protocols
  • Selection of criteria
  • Measure performance
  • Review and modify
  • Repeat

16
Protocols - EBVM
  • Establish a protocol using EBVM
  • The conscientious, explicit and judicious use of
    current best evidence in making decisions about
    the care of individual patients. This means
    integrating individual clinical expertise and the
    best available external clinical evidence from
    systematic research
  • Handbook of EBVM, Cockcroft and Holmes (2003)

17
Stages in the audit cycle
  • Preparation
  • Establish protocols
  • Selection of criteria
  • Measure performance
  • Review and modify
  • Repeat

18
Selection of criteria
  • Criteria are explicit statements that define what
    is being measured, and represent elements of care
    that can be measured objectively (NICE, 2002)

19
Selection of criteria
  • DREAM
  • Distinct
  • Relevant
  • Evidence-based
  • Achievable
  • Measurable

20
Stages in the audit cycle
  • Preparation
  • Establish protocols
  • Selection of criteria
  • Measure performance
  • Review and modify
  • Repeat

21
Measure performance
  • Can measure
  • Processes
  • Outcomes

22
Measure performance
  • Establish standards
  • A statement which outlines an objective with
    guidance for its achievement given in the form of
    criteria sets which specify required resources,
    activities, and predicted outcomes. It decides
    the level of care to be achieved for any
    particular criterion.

23
Stages in the audit cycle
  • Preparation
  • Establish protocols
  • Selection of criteria
  • Measure performance
  • Review and modify
  • Repeat

24
Review and modify
  • Assess the full impact of the solution, including
    issues such as compliance and audit design

25
Clinical audit - summary
  • Ongoing cycle of improvement
  • Pick key areas of audit
  • Build an audit team
  • Create a positive working environment
  • Define your criteria and standards carefully
  • Use the best evidence available
  • Exchange data with colleagues
  • KISS
  • (Keep It Simple, Stupid!)

26
SPVS Roadshows 2005
  • Timetable
  • 9.30 Introduction to clinical auditing in
    general practice Bradley Viner
  • 10.00 Evidence based medicine Dr Peter
    Cockcroft
  • 10.30 Interpreting and sharing data Dr. Dave
    Brodbelt
  • 11.00 Tea
  • 11.30 Monitoring standards of performance in
    medical primary care Dr Chris Jenner
  • 12.00 The role of the VN in clinical audit Lisa
    Bluett VN
  • 12.30 Introduction to workshop
  • 12.45 Lunch
  • 13.45 Workshop on the application of clinical
    auditing
  • 15.00 Workshop presentations
  • 16.15 Plenary session questions discussion and
    summary
  • 17.00 End

27
Workshop
  • Each group should submit a proposal for an audit
    of a clinical aspect of veterinary work, making a
    5 minute presentation on it to the rest of the
    participants at the end, and fielding questions
    on its value and feasibility. The example used is
    likely to be hypothetical, but the topic chosen
    and the environment in which it is applied should
    be real
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