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In the UK, @HQIP National Clinical Audits provide public reports of #data on health care & outcomes, but their potential for quality improvement is not fully realised https://onlinelibrary.wiley.com/doi/10.1111/jep.13403#.YAn3DC4BO-U.twitter
Healthcare systems worldwide devote significant resources towards collecting #data to support care quality assurance & improvement.
The UK National Clinical Audits are intended to contribute to these objectives by providing public reports of data on healthcare treatment & outcomes, but their potential for quality improvement in particular is not realized fully among healthcare providers.
We explored this outcome from the perspective of hospital boards & their quality committees.
We carried out semi‐structured, qualitative interviews with 54 staff in different clinical & management settings in 5 #NHS hospitals about their use of NCA data, & the circumstances that supported or constrained such use.
We used Framework Analysis to identify themes within their responses.
Members & officers of hospitals' governing bodies perceived an imbalance between the benefits to their institutions from National Clinical Audits & the substantial resources consumed by participating in them.
This led some to question the audits' legitimacy, which could limit scope for improvements based on audit data, proposed by clinical teams.
“I haven't got 6 months. I can't do something & fingers crossed & hoping 6 months later that it's got better. We're talking about mortality: that's not reasonable. So I have to actually put in additional metrics to make sure that we're monitoring things“ Quality committee member
“You need to resource both the system to do it & the people to enter it. It isn't necessarily a by‐product of the care you're delivering, it can be an overhead, a burden on top of the care […] “”Institutional information manager
Areas for development could include: 1) moving from an emphasis on cumulative, retrospective reports to real‐time reporting, clearly presenting the “headline” outcomes important to institutional bodies and staff. @cwwalker10
2) Negotiation between hospitals, suppliers & their commissioners about the nature & volume of data the latter are expected to collect.
3) Wider use by hospitals of routine clinical data to populate audit data fields. #DigitalTransformation
4) Developement of interactive digital technologies to help staff explore & report audit data in meaningful ways. @LthtQuality @philwoodLTHT
An exemplar being the ‘need’ to provide real time reporting of #NHS admissions #heartattack & #heartfailure during #COVID19. @BcsPresident @BCIS_uk @BSHeartFailure @ProfNickLinker @CardiacAudit
Here’s a time series of such admissions in 2020 vs. pre #COVIDUK
@QualDash offers the opportunity to integrate hospital level #MINAP @CardiacAudit data into an interactive visualisation dashboard. Quality Indicators (aligning with national guidelines & standards) may be programmed https://qualdash.wordpress.com/
