In NHS Trusts there is now more emphasis on the accountability of quality management on Chief Executives, not only ensuring that minimum standards are met and monitored throughout the organisation, but now how these results are regularly pubished to the public.
This meas that clinical audit and patient experience teams need to provide their NHS Trust Boards with more comprehensive, qualitative information than ever before. However, despite some progress, there are, within Trusts, still some barriers to overcome in order to achieve effective clinical audit and patient experience surveys:
Resistance - Within the NHS the terms clinical audit or patient experience can elicit a variety of negative responses, primarily: frustration, misunderstanding and very rarely enthusiasm. However, under good management and with the right tools and systems in plac, clinical audit can achieve important and measurable improvements in patient care as a matter of routine.
Organisational culture – Many clinicians and managers fear that participation in clinical audit will lead to punishment of poor performers or even litigation. NHS organisations need to make it clear that it is safe to reveal mistakes and that, as a result, lessons can be learnt.
Information requirements need re-addressing – Continual improvement of clinical service quality depends on accurate clinical information being availble to clinicians, managers, service users and the public. This information can come from a variety of sources, which may include: internal IT management systems, patient focus groups, surveys, specific databases and routine audits. Frequently, information needs must be reassessed and systems identified, to provide the information in a way that makes it useful.
Inefficiency – Although the adoption of technology solutions has increased in the NHS over the last 20 years, many departments continue to run independently of each other, preventing the free-flow of communication. Some clinical audit departments continue to process audits and survey forms with inefficient manual systems. Now is the time for them to adopt a comprehensive Trust-wide approach to information collection, that minimises clerical effort and utilises modern technology in a way that both improves the quality, timeliness and availability of this critical information.
Low prioritisation – Previous to the recent Government Whitepaper, clinical audit has been a low priority for some NHS organisations, often seen as time-consuming, not relevant and expensive. Some Chief Executives and Trust Boards have rarely considered clinical audit as an organisational priority so instead, topics for clinical audit have been identified and undertaken according to departmental preference. As a result, the data is rarely shared across the organisation.
Lack of investment – Low prority leads to a lack of investment, both in terms of adequate staffing and supporting systems, as well as necessary administrative resourcesw.
All of these barriers to clinical audit must be addressed if NHS Trust are to achieve the Government’s ambitious objectives. Good quality, accessible data is essential to effectively support management and bring about improvements in patient care and outcomes.
Formic works in partnership with hospitals and healthcare professionals in order to deliver highly robust, proven and fit-for-purpose clinical audit and patient experience survey solutions.
