Views on national audits
Background
Since the start of December 2006, the Clinical Audit Support Centre have requested views from clinical audit and healthcare professionals that have participated in national clinical audit projects. CASC have asked for positive and negative views to help inform the debate on this topic which is due to take place at the Clinical Audit Conference in February. CASC would like to thank those who have kindly returned comments and details are provided below. If you have any views that you would like to share, please email them to info@clinicalauditsupport.com All correspondence will be treated in confidence and anonymity is assured.
View 1
Although national audits build up a national picture of current provision sometimes they are more data collection exercises which do not measure against specific standards. Further, they are sometimes not representative to allow local organisations to get a good understanding of provision at a local level. Some data capture periods are lengthy and current information can be lost. Web based tools can be difficult to navigate. However, analysis is done by others so cuts down on workload.
View 2
National audits are extremely time consuming – especially if photocopying patient notes is required (which as an audit professional always worries me anyway). National audits could give structure to the annual audit programme. Results are slow to come back and become irrelevant. Not hugely positive sorry! But the Trust is always prepared to be involved in national audits.
View 3
Our local Diabetes Audit was more detailed and much better than the national Diabetes Audit. All local practices happily took part in the local audit and used templates to create robust disease registers. The audit identified local problems and action planning helped improve patient care – which was endorsed through re-audit and re-re-audit! The local audit was also very quick and simple to use (unlike the national audit). Results were available within 48 hours of submitting data and comparative data was available at PCT and countywide levels.
View 4
I am finding great difficulty with national audits due to lack of resources and low morale. I am trying hard to engage clinicians in projects, especially those on falls and continence.
View 5
My view of national audits is simple. We collect lots of data and send it off and then never hear anything again!
View 6
National audits are of varying degrees of usefulness and quality. One, designed by the Prescribing Observatory for Mental Health, was quite a useful audit of antipsychotic prescribing. It was good to have someone design an audit for us that we really needed to get done anyway. The results we got however were rather vague and not very helpful. The National Audit of Violence has so far been useful, but it is very time consuming.
The worst so far has been an audit of the NICE Schizophrenia guideline by the Healthcare Commission. A combination of the Healthcare Commission not contacting the audit department about it despite quite tight deadlines and the wording being unclear or just wrong (they asked about advance directives and crisis and contingency plans in the same standard as though they are the same thing). This meant that the audit was difficult to organise and antagonised a lot of clinical staff who we needed to collect the data. The audit produced results that were unusable. It’s difficult enough to engage clinical staff in audit and when demands are made on them and the audit team can’t produce any useful results or recommendations it tends to undo any progress the clinical audit staff have made.
National audits should be useful but they would be better off done as local audits. The focus should be on quality improvement and not just data collection.