Independent feedback on clinical audit performance: a multi‐professional pilot study

Abstract

Purpose -The purpose of this paper is to investigate the acceptability and educational impact of independent feedback on the clinical audit performance of different groups of healthcare professionals by trained colleagues. Design/methodology/approach -This is a pilot study involving review of the criterion audit and significant event analysis (SEA) attempts of west of Scotland dentists, pharmacists, physiotherapists, practice managers and nurse practitioners by trained colleagues using validated instruments. Audit, SEA and feedback reports were content-analysed. Data on pre-and post-study attitudes, experiences and knowledge levels were collected by questionnaire. T-tests for differences in mean group scores were calculated, along with 95 per cent confidence intervals for mean differences. A difference in mean scores of 1.0 or greater would be indicative of educational gain. Findings -A total of 34 participants submitted 54 audit and SEA reports, with 20 submitting both (58.9 per cent). In total, 14/20 audits (75.0 per cent) and 26/34 SEAs (76.5 per cent) contained evidence of appropriate learning needs and action(s) implemented for healthcare improvement. Feedback focused on knowledge and skills in applying audit methods; demonstrating insight into deficiencies; highlighting appropriate learning needs; and implementing change. Audit knowledge and skill scores increased by a mean difference of $ 1.0 for most stages of audit and SEA method (p , 0:001). Strong agreement on the value of independent feedback on clinical audit was reported.Research limitations/implications -The study highlights some of the difficulties in applying audit methods across professions and highlights the added value of feedback by trained colleagues, but is limited in size. Practical implications -Integrating clinical audit and peer feedback with continuing professional development obligations may facilitate greater engagement and more effective quality improvement, but will require a policy change and additional resource. Originality/value -This small study provides further evidence of the acceptability and educational impact of independent feedback on clinical audit performance for healthcare professionals.

It's good to talk: auditing clinicians' interactions with patients in a primary care setting

“…The positive audit results do substantiate the findings from the literature review of authors such as Bowie et al (2009); Lordan (2009) and McKinstry (2010) who concluded that HCPs did provide an equitable service compared with doctors. This reaffirms the multidisciplinary approach to care used within the organisation which contributes to organisational effectiveness and efficiency (Bowie et al , 2009).…”

“…The Royal College of General Practitioners (2007) endorse the use of formative feedback suggesting that the provision of any feedback is important to learning but also potentially impacts on the patient and ultimately promotes improvements in care. This is further endorsed by Bowie et al (2009) who highlight that feedback is greatly appreciated among the health care practitioners who they approached in their study and it also facilitated improvements in care. The Royal College of General Practitioners (2007) tool can additionally be viewed as a resource to identify health care practitioners who may be struggling and need support, as well as those who are providing an excellent service.…”

A realist synthesis of multicentre comparative audit implementation: exploring what works and in which healthcare contexts

“…Defined data collection processes which were easy to follow facilitated data accuracy, completeness and trustworthiness 30 33 43 45 46. Vague definitions impeded data collection 37 47.…”

“…Broadly, feedback processes that were overly critical created a blame culture that resulted in disenchanted participants and an audit that was not capable of generating sustainable quality improvement 11 59 77. Formative feedback that was non-punitive, helpful and task specific facilitated the intrinsic motivation of stakeholders to improve care quality 38 45 78 79…”

Infection prevention and control self-audit: just a tick box exercise?

“…The history and proliferation of audit is well documented (Power, 1994; Holden, 1999; Bowerman et al, 2000; Humphrey and Owen, 2000; Bowie et al, 2009; Levy and Rockall, 2009). The role of audit within the National Health Service (NHS) in England was outlined as part of the government white paper ‘Working for Patients’ (Department of Health, 1989a).…”