The role of QA / QI in Obstetric Anaesthesia PDF
Preview The role of QA / QI in Obstetric Anaesthesia
The role of QA / QI in Obstetric Anaesthesia Guy Godsall MBBS BChemEng BSc FANZCA MClinTRes There are four key things that I want you to take away from this presentation Whilst Audit is important to obstetric anaesthesia • The importance of a single dataset with established data definitions • Benefits of longitudinal data analysis Awareness of a statewide obstetric registry APPENDIX 10 Clinical audit – guidelines DESCRIPTION A clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria. Its objectives are to measure the outcomes of patients against accepted standards, and to recommend changes if the standards are not met. The process may be repeated in a cycle of quality improvement. A clinical audit may involve one specialist or a group of doctors in single or multiple disciplines. EXAMPLES A comparison of procedures, processes or outcomes of health or patient care in anaesthesia, perioperative medicine or pain medicine, with best practice standards in that domain. An audit of the outcomes of a department or group of anaesthetists, compared with the state, national or international benchmarks. An audit of own clinical performance in an area of practice compared with those of peers (department or group of colleagues). APPROACH Any clinical audit can be conducted using the following steps: 1. Decide on a topic or domain that entails anaesthesia/pain or perioperative management. 2. Look into best practice for the topic or domain – research evidence or authoritative opinion (refer to link below). 3. Consider the indicators that may demonstrate performance. 4. For this audit identify the: a. Proposed standard or target for best practice. b. Selection criteria. c. Data to be collected. d. Process for collection of data and timeframe. Audit examples The Royal College of Anaesthetists (RCoA) has developed a publication titled “Raising the Standard: a compendium of audit recipes for continuous quality improvement in anaesthesia”, which provides examples of achievable audits focused mainly on measurement against defined process standards. ANZCA graciously acknowledges the RCoA willingness to make this document available for our Participants. The RCoA audit recipes may be found by following this link: Audit Recipe Book. ANZCA has also created a number of audit templates, developed by Fellows from across Australasia. These may be found on the CPD section of the ANZCA website via this link: Clinical Audit samples. For practical information on how a clinician or group carrying out an audit can ensure the right cases are selected for clinical audit, including determination of the sample size, refer also to the Health Quality Improvement Partnerships document available via the link below (p8) Guide to Ensuring Data Quality in Clinical Audits. 5. Collect the data. 6. Compare the data against chosen standards. 7. Summarise audit outcomes and discuss with a colleague who can provide meaningful feedback on the findings. It is recommended that participants complete the “audit loop” by writing a report on outcomes arising, and recommendations and implemented changes if performance falls short of standards. This could include presenting your findings to peers locally and more widely if possible. Additional credits can be accrued by taking these extra steps (two credits per hour). Appendix 10 | 1 of 2 DEVELOPMENT OF SUPPORT FOR AUDIT AND REGISTRY PROJECTS FOR QI CAPACITY IS A KEY PRIORITY FOR ANZCA Audit is a foundation element of Quality Assurance Audit information allows us to understand how good we really are Single point estimate is often confusing Quality Improvement is leveraged off good QA Institute for Health Improvement QI Essentials Toolkit • Cause and Effect Diagram • Driver Diagram • Failure Modes and Effects Analysis (FMEA) • Flowchart • Histogram • Pareto Chart • PDSA Worksheet • Project Planning Form • Run Chart & Control Chart • Scatter Diagram IHI’s QI Essentials Toolkit includes the tools and templates you need to launch and manage a successful improvement project. Each of the nine tools in the toolkit includes a short description, instructions, an example, and a blank template. Copyright © 2017 Institute for Healthcare Improvement. All rights reserved. Individuals may photocopy these materials for educational, not-for-profit uses, provided that the contents are not altered in any way and that proper attribution is given to IHI as the source of the content. These materials may not be reproduced for commercial, for-profit use in any form or by any means, or republished under any circumstances, without the written permission of the Institute for Healthcare Improvement. There are many benefits to QA/QI projects Improving Quality Together IThe PPuubvblIiifslc iiy stHh opweeue–awd orJwl pwetubdohlal.yieaui Ilf aWQ nlf“l1oy dedTIT 0af mr p.o ll0ueWweiayp0knn,siiara edd mt oBLllNl eeeevduotipHrTvssioaisfrsn..mehSipfr otnngf n siaaievIfThs e ntinorQenI rn ssmtg drwusmus.g u oiiu sosapuu ionMeietplkflasdrtngl inrar. o ite fev”sonntaayvrm i in Togastnos emic Tr ncrughdmemarooaope pT es Negmda uterlp ah ,ee epuHQnr oddmrmate PaarcbStuosrihomo gi efe otuaenIwWfvews,mtul.nerg i i h py tatwdotard Ihphcitsyel lef chea lhIreW nTg drhQItsisosaT mteice . aItv ngbvimaohcpalspeigyeic, h fevpsrQnp hep fsen rovNr rg it astn–ionvtohHp rqo o egvQueavetueSu miani bsc HuonedwWp dtrmafeaegsaeihpi av nanflscoQsleuill tylghaelttau re nahiaGyes tata cr.n h h tultblBb oeTdeieeionotedmoyd asryuia geem tvam traT te o pdh tbfoioactiemp a regna hclisedGpibn eh eltrugan-rhdo sln iaeu t vEqtgotrreo oduuy m enigae iixtemagsdepit tenolapih otnanrefeisnoodr.nrav bllehe oe at whr nei ng TIhmeT Imhpprerovo IimnQpvgro vQueinugma aQluilatliyiety tT Tnooyggete thte hrGer uEdiitdione 1The 100f0r ILniovecms Plluu sa dQcuearlistoy Isemspxr oaWvemmaenplt eGluseid!es of IQT projects
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