OPEN QIMANAGE, SHARE, COLLABORATE

Dr Conrad Lee (BSUHT)Dr Michael George (PHT)

The NHS strives for continued quality improvement and innovations

The Care Quality Commission requires all organisations to

submit a Quality Account

“You must take part in systems of quality assurance and quality improvement to promote patient safety.”

- GMC Good Medical Practice 2013

It is now compulsory for clinicians to participate in clinical audits, as one of

the pillars of clinical governance.

Clinical Audits?

QUALITY IMPROVEMENT

#FMLMQI twitter chat

NHS trusts that have junior doctors have a built-in supplement to the clinical audit workforce.

Are we utilising this process effectively to improve care quality and educate our staff?

Multiple studies show substantial improvement in clinical care is only possible through completing audit cycles.

Singh et al 2013

Iqbal et al 2010

Guryel et al 2008

Venkatesan et al 2011

Gnanaligham et al 2011

John et al 2004

17% of

clinical audits were

Completed

Only

Only 5% of audits led to any change in the practice or process studied http://careers.bmj.com/careers/advice/view-article.html?id=20002524

Considerable time and resources are

wasted on projects that get abandoned…

?

Project initiation

Project management

Collaboration

Project initiation

Where are the resources to help generate good QI project

ideas and design?

What are the priorities of my department?

Frontline staff often see practices that can be improved…but where can they collate these ideas?

How can we stop reinventing the

wheel?

Out of 10 hospitals surveyed in KSS…

All hospitals take part in QI.

Surrey

Sussex

Kent

Out of 10 hospitals surveyed in KSS…

All hospitals are require audit projects to be registered

Surrey

Sussex

Kent

Out of 10 hospitals surveyed in KSS…

only 1 have an online audit database that is openly accessible to their clinicians.

Surrey

Sussex

Kent

Project management

With frequent changeovers of clinicians ...

There simply isn’t enough time for re-audits to be done in a single clinical rotation.

Lack of project continuity

No robust project management tool for departments/ trust

?

Good QI Projects are

just evaporating into thin air…

”Tell people how you did…If you succeed, explain what was key to that success; If you fail, tell people why this happened.

Going beyond audit – Riaz Dharamshi, Toby Hillman

Networking & Collaboration

“It is a bold agenda. We need to not just innovate, but also be sure that we are sharing those innovations all across the country” – From innovation to Action: The

First Report of the Health Care Innovation Working Group

Current collaboration methods

conferences

OnlineJournals

The Sharing Good Practice event

KSS prize day

Clinical Audit Support Centre (CASC) annual junior doctor clinical audit conference

National Clinical Audit Forum (NCAF)

The Clinical Audit Support Centre , Leicester

Senior involvement and MDT approaches are key to bringing change in clinical practise

What

• An electronic platform for storing and sharing ideas / projects

• Facilitate ease for healthcare professionals to monitor and manage QI projects

• Readily and freely available on the internet

• Online support and collaboration

…

We should embrace the technology!

OPEN QI

MANAGE, SHARE, COLLABORATE

Benefits - in summary

• Increase and streamline QI activity

• Greater control of QI projects

• Improve continuity and completion of projects

• Encourages collaboration and sharing of ideas

Collaboration

• Software compatibility • First step in regional collaboration

The proposal

• Resources and expertise to help develop and maintain this online platform

• Senior / trust involvement in educating doctors in QI and increase awareness of the online platform

• Structuring responsibilities

"Our vision is that someday, through OpenQI, each hospital can share, learn, and be proud of every single Quality Improvement project they

have done.”

Acknowledgments Craig Thomas (Web developer, Cardiff)

Dr Sebastian Yuen (Consultant Paediatrician, Bristol)Jo Carter (Director of SatoriLab, Cardiff)

Nick Theodorou (Project manager, London)

Acknowledgments

Mark Renshaw (Deputy Chief of Safety)Eirwen Record (Clinical audit facilitator)

Tom Roper (Clinical Librarian)Mr Anil Ghosh (General Surgical Registrar)

References

THANK YOU

Dr Conrad Lee @ckwl1

Dr Michael George @drmgeorge87

#OpenQI

@OpenQI

•http://careers.bmj.com/careers/advice/view-article.html?id=20002524•“Audit of audits in an orthopaedic university teaching hospital: eight and a half years of experience” R Singh et al; Ann R Coll Surge Engl (Suppl) 2013; 95: 59-61•“Auditing orthopaedic Audit” E Guryel, K Acton, S Patel; Ann R Coll Surge Engl; 90: 675-678•“Going beyond audit” Dharamshi, T Hillman; BMJ careers 2011 http://careers.bmj.com/careers/advice/view-article.html?id=20003642•“The way we see it: Quality improvement” T Hillman, A Roueche •Venkatesan M,Amin RB,Armitage A. Standards and effectiveness of the orthopaedic quality improvement process: review of a decade of audit database. OJCA 2011; 3(2).•Gnanalingham J, Gnanalingham MG, Gnanalingham KK. An audit of audits: are we completing the cycle? J R Soc Med 2001; 94: 288–89.•C M John, D E Mathew, M G Gnanalingham. An audit of paediatric audits Arch Dis Child 2004;89:1128–1129.