“This was a huge piece of work that could not have been done without using Formic Fusion scanning software, due to the sheer scale of the project.”
Jim Chapman, Clinical Audit and Quality Manager, Sheffield Health & Social Care Foundation Trust.
Sheffield Health & Social Care Foundation Trust is the main provider of a wide range of specialist health and social care services to individuals and their carers or families in Sheffield.
The Trust provides:
- Mental health services for adults and older people
- Services for people with learning disabilities
- Services for people with drug and alcohol problems
- A wide range of other specialist services, such as for people accessing maternal mental health, gender dysphoria services and psychology for people with physical health problems
THE PROBLEM
On an annual basis the Trust has to submit a Trust-wide Records Audit. This is for the NHS Litigation Authority and is to ensure that the Trust has an appropriate standard of documentation. In reference to the Nursing Times 2009, ‘Good record keeping is essential for patient care and safety. Health professionals should be able to look in the notes and continue caring for the patient in a seamless continuum. If a named professional was unable to return to work, then from the patient’s point of view, this should make no difference to the care they receive.’
THE SOLUTION
The audit proforma was designed using Formic Fusion software to meet the requirements of the NHS Litigation Authority and The Care Quality Commission. It included clinical input from the teams and directorates, 64 of who were involved in the initial audit 2008/2009.
Jim Chapman, Audit & Knowledge Manager, Sheffield Health & Social Care Foundation Trust, explains the results: “Following the initial audit, data was analysed in SPSS and all teams were sent a laminated card of the results. Teams were also sent an electronic web link that they could cut and paste into their team reports. The audit results were presented at numerous forums and this gave teams the opportunity to benchmark.
The audit was then repeated in 2010. This was a huge piece of work that could not have been done without using Formic Fusion scanning software, due to the sheer scale of the project.”
The project included:
- 340 data collection forms
- 65 questions on each form
- 7 page (duplex) form
- 2380 pages to scan
Following the re-audit in 2010 there were 15 significant improvements in practice and 5 significant reductions.
CONCLUSIONS
The audit will be repeated again in 2011. There were further areas of documentation for the Trust to improve upon, including:
- Maintaining links with the service user in the care plan
- Discussing risk assessment at MDT
- Assigning names to action plans in the risk assessment
- Documenting the level of risk
- Keeping in contact with the service user
- Advance directives, HoNOS, asking about abuse, advising GPs and copying letters to patients.
LESSONS LEARNED
“This has been an excellent project because it was not just about ‘ticking the box’ and ‘feeding the beast’. Teams were involved in the project and actually audited each other to remove bias. All teams received laminated cards and a web based copy of their results.”
“The challenge for this year will be to make the project more multidisciplinary. In the most recent audit, we used the actual form designing in Formic Fusion, as opposed to a form designed on the legacy module. This made scanning easier. We also had all of the forms printed externally.
Overall the audit has shown improvements and there are further areas to work on. It is an evolving audit tool that will be reviewed and amended again this year, before the 2011 audit is carried out. Getting the Chief Executive to put his name on the covering letter also gave the project plenty of kudos.”
Formic has 20 years’ experience in helping NHS Trusts deliver paper, online, PDA, touchscreen and kiosk surveys, with tools to help engage with staff, patients and other stakeholders.
Formic clinical audit and patient experience software solutions can handle every step of the survey process, from questionnaire design and publication to data analysis. An increasing number of our NHS customers are now successfully trialling Tablet PCs to collect patient experience and clinical audit data.
- Easily design survey forms once and deploy it in many different formats (modes) – i.e. paper, web, kiosk, touchscreen, tablet pc and PDA
- Collect data on the move - with PDA’s, moveable kiosks, tablet PCs
- Scan paper surveys for more efficient patient experience and clinical audit data capture - up to 50 times faster
- Rapidly collate, analyse and share results with staff, stakeholders and patients
Find out more:
Putting the Patient at the Centre of the NHS.
Formic looks at how the NHS can meet the challenge of providing openness, transparency and comparability of information to the patient, with the launch of a new Whitepaper.
“At present, PROMs, other outcome measures, patient experience surveys and national Clinical Audit are not used widely enough. We will expand their validity, collection and use.”
These are the words of the Secretary of State for Health, Andrew Lansley, in his 2010 Whitepaper for the NHS. He goes on to say that more widespread use of patient experience surveys and real-time feedback will be encouraged, and that patients will be able to rate services and clinical departments according to the quality of care they have received. Hospitals will have to be more open and accountable about mistakes and staff feedback will play an important role in making improvements to the quality of patient care.
Patient experience and patient outcomes monitoring is closely related to clinical audit, and can be part of a clinical audit, alongside other measurements of the patient experience as a whole. Programmes such as these seek to improve not just treatment outcomes but also the patient’s overall experience.
These projects can collect a lot of information, including physiological, medical and personal information, which, in many NHS Trusts, is held in multiple clinical databases. The programmes also measure survival rates and the physical improvement of the patient. Various results are often adjusted according to the ‘case mix’ so that reliable evidence can be made available for clinicians, managers, patients and the general public.
The area of monitoring treatments, feedback and the setting and achieving of clinical audit and patient experience objectives will becom of increasing focus for NHS Trusts. Whilst most Trusts already have teams in plac that are experienced in clinical audit and statistical analysis, these have been predominantly focussed on gathering information from internal clinical sources. The switch in emphasis toward patient experience feedback will mean that they now have to put in place the methods and processes for obtaining this information in volume, whilst ensuring its quality. Given the financial constraints that are likely to apply to these teams, they will need to find innovative ways of doing this, rather than apply those traditionally used.
Of course the success of any patient experience evaluation is only made possible with accurate and up to date information. Technology can play an ever-increasing role in making information more efficient and more reliable.
Formic recognises the importance of the changes outlined in the Government’s White Paper and our experience has led us to believe that accurate, efficient and cost-effective information capture, management and sharing, will soon play a critical role as an enabling factor for many of the changes outlined.
Find out more.
