The Barts Health Approach

Delivering National Clinical Audit

Emerald Toogood Project Lead

Content

• People and practice • Our approach to learning from clinical audit • Our approach to obtaining data for clinical audit • Our approach to outlier investigations • Sharing clinical audit with stakeholders

Context

• Over 15,000 staff • More than six sites • Our vision and values: • Relentlessly improving and innovating for patient safety • Achieving ambitious results by working together • Valuing every member of staff and their contribution to the care of our patients

People

• Central Clinical Effectiveness Unit sits within the Business Intelligence Unit • Clinical Effectiveness Leads in each specialty plan the specialty audit programme • Lead Clinician • Junior Doctor • Administrator (eg MDT Coordinator)

Specialty programme

• Presentation date • Local projects, informed by national audit project results/design • Caveat: areas with high volume of national audit activity (eg BTS) are local priorities being addressed?

Committee review – the content

First committee meeting within one month of the report publication Second committee meeting when all actions have been achieved

Policy

Participation in national clinical audit is a Barts Health priority agreed by the Trust Board ‘National clinical audit and management of outliers’ policy in addition to local audit policy, incorporates • • • • • • • Roles and responsibilities (eg registration, both with the supplier and internally) Information governance Data quality Personal development Service improvement principles Outlier management Sharing good and bad news

Data sources

Access to paper records Identifying patients for clinical audit Using CRS-derived data - improving data quality and completeness - getting the diagnoses and problems right for each patient.

Collaboration platform

Outlier investigation

• Who undertakes the investigation • Checking data, including date of death, age, sex, disease severity, co-morbidity • Global trigger tool • Use of routinely available data, risk management systems, clinical due diligence

Key points

• Bring the right people together to better understand their service • Make sure that the team knows what to do and when • Simultaneously improve data quality and completeness • Use local audit to complement the national audit programme, not forgetting local priorities • Use national audit data in conjunction with routinely available data – a key element of letters of representation and due diligence