DOCSLIB.ORG

Toolkit to Develop and Strengthen Medical Audit Systems

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Toolkit to Develop and Strengthen Medical Audit Systems Toolkit to Develop and Strengthen Medical Audit Systems Practical Guide by Implementers for Implementers December 2017 2017 심사평 메뉴얼북 표지.indd 2 17. 11. 29. 오후 8:26 2017 심사평 메뉴얼북 표지.indd 3 17. 11. 29. 오후 8:26 Toolkit to Develop and Strengthen Medical Audit Systems Practical Guide by Implementers for Implementers December 2017 2017 심사평 메뉴얼북 내지 책.indb 1 17. 11. 29. 오후 8:39 THIS GUIDE WAS PRODUCED by the Joint Learning Network for Universal Health Coverage (JLN), an innovative network of practitioners and policymakers from around the globe who engage in practitioner-to-practitioner learning and collaboratively develop practical tools to help countries work toward universal health coverage. For inquiries about this guide or other related JLN activities, please contact the JLN at [email protected]. This work was funded by a grant from the Rockefeller Foundation and by the Government of South Korea. The views expressed herein are solely those of the authors and do not necessarily reflect the views of the organizations. Note: This is the first release of the Medical Audits Toolkit. The toolkit has been reviewed by the participants of JLN’s Medical Audits collaborative, under which the product was developed. Attempts have been made to have the toolkit reviewed by external experts, such as medical audit professionals. A more rigorous review by external experts, along with feedback from countries will be incorporated to make it a comprehensive guide for use by countries looking to strengthen their medical audit systems. Revised version(s) of the toolkit will be available at www.jointlearningnetwork.org. This product is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-sa/4.0/legalcode. The content in this document may be freely used and adapted in accordance with this license, provided it is accompanied by the following citation. RECOMMENDED CITATION “Toolkit for Medical Audit Systems: Practical Guide from Implementers to Implementers, Copyright © 2017, Joint Learning Network for Universal Health Coverage, ACCESS Health International.” If translated or used for educational purposes, please contact the Joint Learning Network at [email protected] so we may have a record of its use. Product and company names mentioned herein may be the trademarks of their respective owners. Version: December 2017 2017 심사평 메뉴얼북 내지 책.indb 2 17. 11. 29. 오후 8:39 Authors Vivian Addo-Cobbiah, National Health Insurance Authority, Ghana Amin Ahmad, Ministry of Health, Malaysia Sofi Bergkvist, ACCESS Health International, USA Tricia Bolendar, Quality and Systems Improvement Consultant Sudha Chandrashekhar, Suvarna Arogya Suraksha Trust, India Gilda Salvacion Abrenica Diaz, Philippine Health Insurance Corporation, Philippines Lydia Dsane-Selby, National Health Insurance Authority, Ghana Uchenna Eugenes Ewelike, National Health Insurance Scheme, Nigeria Joseph Githinji, National Hospital Insurance Fund, Kenya Bhavesh Jain, ACCESS Health International, India Young Ae Jeong, Health Insurance Review and Assessment Service (HIRA), South Korea Helen Wambui Kairie, Ministry of Health, Kenya Sireesha Perabathina, ACCESS Health International, India Mercy Picorro, Philippine Health Insurance Corporation, Philippines Vyoma Dhar Sharma, ACCESS Health International, India Sylvia Sumpay, Philippine Health Insurance Corporation, Philippines Francis Ukwuije, Ministry of Health, Nigeria Contributors Joseph N O Ana, Africa Centre for Clinical Governance Research & Patient Safety, Nigeria György Bèla Fritsche MD, Senior Health Specialist, World Bank, USA Taeyeon Kim, Health Insurance Review and Assessment Service (HIRA), South Korea Eunjung Lee, Health Insurance Review and Assessment Service (HIRA), South Korea Eunyoung Lim, Health Insurance Review and Assessment Service (HIRA), South Korea Sinit Mehtsun, Results for Development, USA Isaac Charles Noble Morrison, Society of Private Medical & Dental Practitioners, Ghana Cheluchi Onyemelukwe, Health Ethics and Law Consulting, Lagos, Nigeria Sergio Ivan Prada Rios, Universidad ICESI & PROESA, Colombia Eka Yoshida Sofyan, Ministry of Health, Indonesia Memunatu Abass Tanko, National Health Insurance Authority, Ghana Mary Wairimu Wangai, Ministry of Health, Kenya Aman Fuad Yacob, Ministry of Health, Malaysia 2017 심사평 메뉴얼북 내지 책.indb 3 17. 11. 29. 오후 8:39 ACKNOWLEDGEMENTS This work was made possible with generous support from the government of South Korea. The Health Insurance Review and Assessment Service of South Korea contributed valuable technical expertise, organized all three learning events in Wonju for the Medical Audit Collaborative, and provided generous financial support. We would also like to thank all the governments of the members of the Medical Audit Collaborative for allowing members of the collaborative to leave their busy daily jobs in their home countries to make their contributions. We gratefully acknowledge the financial support of the Rockefeller Foundation. Special thanks go to Natalie Phaholyothin at the Rockefeller Foundation for introducing John Ryu at the Health Insurance Review and Assessment Service, who then took the technical lead for the collaborative. The authors of this toolkit include all members of the Medical Audit Collaborative. They must each be acknowledged for the experiences, data, and materials they contributed from their respective countries. The editors wish to acknowledge JLN Country Core Group leads and international partners, and Dr. György Bèla Fritsche MD, Senior Health Specialist, World Bank, who reviewed and provided valuable feedback on draft versions of this document. Finally, the authors acknowledge the support of technical initiatives of the Joint Learning Network, including the Information Technology and Provider Payment Mechanisms for important groundwork on data analysis for provider payment systems. Caren Althasuser from the Information Technology Initiative was particularly helpful in determining the process for the chapter on functional requirements. 2017 심사평 메뉴얼북 내지 책.indb 4 17. 11. 29. 오후 8:39 TABLE OF CONTENTS ACKNOWLEDGMENTS 4 Chapter 1. Introduction to the Toolkit 7 1.1 Who can Benefit from This Toolkit 8 1.2 Medical Audit System Framework 9 1.3 How This Toolkit is Organized 11 1.4 Key Definitions 14 Chapter 2. Preconditions for Medical Audit Systems 17 2.1 How to Develop an Effective Governance and Administration Structure 18 2.2 Human Resources - How to Build an Effective Team 37 Chapter 3. Processes of Medical Audit Systems 53 3.1 Indicators 55 3.2 Triggers and Actions 70 3.3 Integration with the Activities 80 3.4 Functional Requirement 116 Chapter 4. Outcomes of Medical Audit Results 131 References 146 Appendix 147 2017 심사평 메뉴얼북 내지 책.indb 5 17. 11. 29. 오후 8:39 CHAPTER CHAPTER Introduction to the Preconditions for Toolkit Medical Audit Systems CHAPTER CHAPTER Process of Outcomes Medical Audit System 2017 심사평 메뉴얼북 내지 책.indb 6 17. 11. 29. 오후 8:39 CHAPTER INTRODUCTION TO THE TOOLKIT 2017 심사평 메뉴얼북 내지 책.indb 7 17. 11. 29. 오후 8:39 Many practitioners and policymakers across JLN membership have expressed a strong interest in establishing or strengthening their medical audit systems. Countries face challenges in creating appropriate governance and structuring human resources for setting up medical audits in their health insurance agencies. Even if a medical audit system is already in place, they face issues in assuring that the medical audits are efficient and effective. Finally, the practitioners were also eager to understand how the results of a medical audit can be used to improve quality of care and reduce the cost of services. The Medical Audit Collaborative was formed with the objective of improving the quality of healthcare through designing and strengthening medical audit systems. To that end, the collaborative decided to develop a practical toolkit on how to design, implement, and strengthen a medical audit system. The Purpose of the Toolkit: This toolkit was created to address gaps in practical knowledge by providing guidance on setting up medical audit units, conducting investigations, and using the results of the medical audit. The toolkit provides a step-by-step review of claims to identify providers prone to fraud or poor quality of care. The toolkit was developed from the perspective of a purchaser of healthcare services. It covers technical guidance and gives practical examples from participating JLN member countries. To support the demand for new knowledge on medical audit systems, South Korea hosted the Medical Audit Collaborative to help other countries learn from the advanced system in South Korea, as well as from each other. All members of the collaborative developed the toolkit together, based on their respective experiences, while getting firsthand exposure to the established medical audit system in South Korea. The toolkit provides a detailed case study of South Korea as a reference case. The toolkit was developed by a group of medical audit practitioners, policymakers, and quality improvement managers from eight countries. Examples and experiences of medical audit systems in member countries appear throughout the toolkit to illustrate how they selected options and identified solutions to some of the common challenges they faced. The toolkit is a collection of advice from practitioners to practitioners. 1.1 WHO CAN BENEFIT FROM THIS TOOLKIT? The toolkit aims to equip the purchasers of health services, like Ministries of Health and
Load more

Recommended publications
  • Clinical Audit/Quality Improvement Projects Guidance for Professional
    Clinical Audit/Quality Improvement Projects Guidance For Professional Competence Scheme Prepared by Faculty of Public Health Medicine December 2012 1 KEY POINTS ON AUDIT FOR PUBLIC HEALTH . This document is produced by the Faculty of Public Health Medicine Ireland (FPHMI) to support and guide participants of the FPHMI Professional Competence Scheme (PCS) to achieve their requirement of completing one clinical audit / quality improvement project each year. This document is a guide for doctors practising public health medicine and who are either on the Specialist or General Division of the Register . All doctors must participate in professional competence . Each doctor must define his/her scope of practice . All doctors whose practice include both clinical and non‐clinical work should engage in both clinical audit and other quality improvement practices relevant to their scope of practice . Audit can be at individual, team, departmental or national level . Each doctor must actively engage in clinical audit / systematic quality improvement activity that relates directly to their practice. ‘The Medical Council’s Framework for Maintenance of Professional Competence Activities’ sets one clinical audit per year as the minimum target. The time spent on completing the audit is accounted for separately from other Continuing Professional Development (CPD) activities. It is estimated that the completion of one clinical audit will take approximately 12 hours of activity. The main challenges in undertaking audit in public health practice include o Lack of explicit criteria against which to measure audit o Timeframes for measuring outcomes which can be prolonged and thus process measures are more readily measured Can’t seem to format this box which is smaller than the text o Changing public health work programmes in Departments .
    [Show full text]
  • Onsite Guide
    A HIA 3 8T H A N N U A L C O N F E R E N C E ONSITE GUIDE SPONSORED BY Scan to download the AHIA Conference App www.ahia.org TABLE OF CONTENTS AHIA MISSION & VISION AHIA Mission and Vision . 3 & VISION AHIA MISSION TABLE OF CONTENTS TABLE Hotel Floor Plan & Site Map . 4-5 Welcome . 5 Schedule of Events by Day . 6-15 AHIA Board of Directors & Conference MISSION STATEMENT Planning Committee . 17 The Association of Healthcare Internal Auditors provides leadership Exhibit Hall Hours & Social Events Schedule . 18-19 and advocacy to advance the healthcare internal audit profession AHIA Conference Tracks . 20-21 globally by facilitating relevant education, resources, certification 2020 Save the Date . 21 and networking opportunities. Conference Schedule Sunday, September 15 . 22-30 VISION STATEMENT Monday, September 16 . 31-44 To be the premier association for healthcare internal auditing. Tuesday, September 17 . 45-59 Founded in 1981, the Association of Healthcare Internal Auditors Wednesday, September 18 . 61-67 (AHIA) is a network of experienced healthcare internal auditing Sponsors . 68-69 professionals who come together to share tools, knowledge and Exhibitor Hours & Drawing . .. 70 insight on how to assess and evaluate risk within a complex and dynamic healthcare environment. AHIA is an advocate for the Exhibitor Floor Plan . 71 profession, continuing to elevate and champion the strategic Exhibitor Listing . 72-82 importance of healthcare internal auditors with executive CPE Certification . 85 management and the Board. If you have a stake in healthcare governance, risk management and internal controls, AHIA is CHIAP™ Certificants . 86–88 your one-stop resource.
    [Show full text]
  • Clinical Audit: a Simple Guide for NHS Boards & Partners
    Clinical audit: A simple guide for NHS Boards & partners Authors: Dr. John Bullivant, Director, Good Governance Institute (GGI) Good Governance Andrew Corbett-Nolan, Institute Chair, Institute of Healthcare Management (IHM) Contents Executive summary Executive summary 3 Whilst this guide is specifically about clinical audit, much of what • Delivers a return on investment. is described here is relevant to the way in which NHS Boards can • Improvements are implemented and sustained. 1. Clinical audit: Ten simple rules for NHS Boards 5 monitor clinical quality as a whole within the context of clinical or integrated governance. A PCT has specific responsibilities in relation to clinical audit that 2. Foreword 7 should be managed through the Professional Executive Clinical audit has been endorsed by the Department of Health in Committee (PEC) or an equivalent committee. 3. Clinical audit as part of the modern healthcare system 9 successive strategic documents as a significant way in which the quality of clinical care can be measured and improved. Originally, Boards should use clinical audit to confirm that current practice 4. Definitions and types of clinical quality review 11 clinical audit was developed as a process by which clinicians compares favourably with evidence of good practice and to reviewed their own practice. However, clinical audit is now 5. The importance and relationship of clinical audit to clinical ensure that where this is not the case that changes are made recognised as an effective mechanism for improving the quality that improve the delivery of care. governance, NHS Boards and their partner organisations 15 of care patients receive as a whole.
    [Show full text]
  • Principles of Surgical Audit
    Principles of I Surgical Audit How to Set Up a Prospective 1 Surgical Audit Andrew Sinclair and Ben Bridgewater Key points • Clinical audit can be prospective and/or • A clinical department benefits from a clear audit retrospective. plan. • Audit information can be obtained from • Clinical audit improves patient outcome. national, hospital, and surgeon-specific data. Much of the experience we draw on comes from cardiac Introduction surgery, where there is a long history of structured data collection, both in the United States and in the United Clinical audit is one of the “keystones” of clinical govern- Kingdom. This was initially driven by clinicians [1–3,5], ance. A surgical department that subjects itself to regu- but more recently has been influenced by politicians and lar and comprehensive audit should be able to provide the media [6,7]. Cardiac surgery is regarded as an easy data to current and prospective patients about the qual- specialty to audit in view of the high volume and pro- ity of the services it provides, as well as reassurance to portion of a single operation coronary artery bypass those who pay for and regulate health care. Well-organ- graft (CABG) in most surgeons practice set against a ized audit should also enable the clinicians providing small but significant hard measurement end point of services to continually improve the quality of care they mortality (which is typically approximately 2%). deliver. There are many similarities between audit and research, but historically audit has often been seen as the “poor relation.” For audit to be meaningful and useful, it Why conduct prospective audit? must, like research, be methodologically robust and have sufficient “power” to make useful observations; it would There are a number of reasons why clinicians might be easy to gain false reassurance about the quality of care decide to conduct a clinical audit as given in Table 1.1.
    [Show full text]
  • Clinical Audit: a Simplified Approach Mansoor Dilnawaz, Hina Mazhar, Zafar Iqbal Shaikh
    Journal of Pakistan Association of Dermatologists 2012; 22 (4):358-362. Review Article Clinical audit: A simplified approach Mansoor Dilnawaz, Hina Mazhar, Zafar Iqbal Shaikh Department of Dermatology, Military Hospital (MH), Rawalpindi Abstract A clinical audit measures practice against standards and performance. Unlike research which poses the question, “what is the right thing to do?” clinical audit asks are we doing the right thing in the right way? An approach for understanding a clinical audit is provided. A basic clinical audit example of a case note audit is presented. A simplified template to help the beginners is included. Key words Clinical audit. Introduction and steps of clinical audit We should determine what we are trying to measure and define gold standards. The next Audit is a key component of clinical stage is about setting the standards. Criteria are governance, which aims to ensure that the those aspects of care that we wish to examine. patients receive high standard and best quality Standards are the pre-stated or implicit levels care.1,2 It is important that health professionals of success that we wish to achieve. The are given protected and adequate time to standards are based on the local, national or perform clinical audit.4,5,6,7 Clinical audit runs international guidelines. They should be in a cycle and aims to bring about incremental relevant to our practice. A couple of example improvement in health care. Guidelines and of the sources includes National Institute of standards are set according to perceived Clinical Excellence (NICE) and the British importance and performance is then measured Association of Dermatologists (B.A.D) web against these standards.8,9,10 .
    [Show full text]
  • Clinical Audit: a Comprehensive Review of the Literature
    CENTRE FOR CLINICAL GOVERNANCE RESEARCH Clinical audit: a comprehensive review of the literature The Centre for Clinical Governance Research in Health The Centre for Clinical Governance Research in Health undertakes strategic research, evaluations and research-based projects of national and international standing with a core interest to investigate health sector issues of policy, culture, systems, governance and leadership. Clinical audit: a comprehensive review of the literature First produced 2009 by the Centre for Clinical Governance Research in Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052. © Travaglia J, Debono D, 2009 This report is copyright. Apart from fair dealing for the purpose of private study, research, criticism or review, as permitted under the Copyright Act, 1968, no part of this publication may be reproduced by any process without the written permission of the copyright owners and the publisher. National Library of Australia Cataloguing-in-Publication data: Title: Clinical audit: a comprehensive review of the literature 1. Literature review method. 2. I. Travaglia J, II. Debono, D. III. University of New South Wales. Centre for Clinical Governance Research in Health. Centre for Clinical Governance Research, University of New South Wales, Sydney Australia http://clingov.med.unsw.edu.au Centre for Clinical Governance Research in Health, UNSW 2009 i Clinical audit: a comprehensive review of the literature Clinical audit: a comprehensive review of the literature Duration of project February to May 2009 Search period 1950 to May 2009 Key words searched Clinical Audit Databases searched Medline from 1950 Embase from 1980 CINAHL from 1982 Criteria applied Phrase Contact details Contact: Jo Travaglia Email: [email protected] Telephone: 02 9385 2594 Centre for Clinical Governance Research in Health Faculty of Medicine University of New South Wales Sydney NSW 2052 Australia Centre for Clinical Governance Research in Health, UNSW 2009 ii Clinical audit: a comprehensive review of the literature CONTENTS 1.
    [Show full text]
  • Exploring Variation in the Use of Feedback from National Clinical
    Alvarado et al. BMC Health Services Research (2020) 20:859 https://doi.org/10.1186/s12913-020-05661-0 RESEARCH ARTICLE Open Access Exploring variation in the use of feedback from national clinical audits: a realist investigation Natasha Alvarado1* , Lynn McVey1, Joanne Greenhalgh2, Dawn Dowding3, Mamas Mamas4, Chris Gale5, Patrick Doherty6 and Rebecca Randell7 Abstract Background: National Clinical Audits (NCAs) are a well-established quality improvement strategy used in healthcare settings. Significant resources, including clinicians’ time, are invested in participating in NCAs, yet there is variation in the extent to which the resulting feedback stimulates quality improvement. The aim of this study was to explore the reasons behind this variation. Methods: We used realist evaluation to interrogate how context shapes the mechanisms through which NCAs work (or not) to stimulate quality improvement. Fifty-four interviews were conducted with doctors, nurses, audit clerks and other staff working with NCAs across five healthcare providers in England. In line with realist principles we scrutinised the data to identify how and why providers responded to NCA feedback (mechanisms), the circumstances that supported or constrained provider responses (context), and what happened as a result of the interactions between mechanisms and context (outcomes). We summarised our findings as Context+Mechanism = Outcome configurations. Results: We identified five mechanisms that explained provider interactions with NCA feedback: reputation, professionalism, competition, incentives, and professional development. Professionalism and incentives underpinned most frequent interaction with feedback, providing opportunities to stimulate quality improvement. Feedback was used routinely in these ways where it was generated from data stored in local databases before upload to NCA suppliers.
    [Show full text]
  • What to Do When an Audit Letter Comes… Sarah Reed BSE,CPC,CPC‐I AAPC Fellow
    What To Do When An Audit Letter Comes… Sarah Reed BSE,CPC,CPC‐I AAPC Fellow 1 The speaker has no financial relationship to any products or services referenced in this program. This program is intended to be informational only. The speaker is not an authoritative source by law. Attendees are advised to reference payer specific provider manuals, on‐line or otherwise, for verification prior to making changes to their coding, documentation and/or billing practices. 2 Content Ms. Reed will address with the attendees the different types of external audits and their purpose (including, but not limited to, CERT, OIG, HEAT,UPIC, ZPIC, MAC, MIC and commercial payer). In addition to defining and educating on what the intent of the audit is, she will provide information on how to respond and track these audits in your practice. Who should be involved ‐ from manager to coding staff to providers ‐ and how should you respond? Ms. Reed will also give some education tips for sharing in the practice so that staff understands the process and the importance of the audit in progress. 3 Slides and Information Please be aware that not all the information presented in todays session is listed on the slides you are viewing. These slides are a base for the presentation. You will need to take notes on specific discussions in the session. Do not be afraid to ask questions and make comments. This is an interactive education session. 4 Time Out • One of first clinical audits was undertaken by Florence Nightingale during the Crimean War of 1853‐1855.
    [Show full text]
  • Principles for Best Practice in Clinical Audit
    Principles for Best Practice in Clinical Audit Radcliffe Medical Press Radcliffe Medical Press Ltd 18 Marcham Road Abingdon Oxon OX14 1AA United Kingdom www.radcliffe-oxford.com The Radcliffe Medical Press electronic catalogue and online ordering facility. Direct sales to anywhere in the world. # 2002 National Institute for Clinical Excellence All rights reserved.This material may be freely reproduced for educational and not for profit purposes within the NHS.No reproduction by or for commercial organisations is permitted without the express written permission of NICE. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. ISBN 1 85775 976 1 Typeset by Aarontype Ltd, Easton, Bristol Printed and bound by TJ International Ltd, Padstow, Cornwall Contents Contributing authors iv Acknowledgements v Foreword vi Clinical audit in the NHS: a statement from the National viii Institute for Clinical Excellence Introduction: using the method, creating the environment 1 Stage One: preparing for audit 9 Stage Two: selecting criteria 21 Stage Three: measuring level of performance 33 Stage Four: making improvements 47 Stage Five: sustaining improvement 59 Appendix I: glossary 69 Appendix II: online resources for clinical audit 73 Appendix III: national audit projects sponsored by the 93 National Institute for Clinical Excellence Appendix IV: further reading 97 Appendix V: key points and key notes 101 Appendix VI: checklists 105 Appendix VII: approach to examining clinical audit during a clinical
    [Show full text]
  • A Guide for Clinical Audit, Research and Service Review
    A Guide for Clinical Audit, Research and Service Review — An educational toolkit designed to help staff differentiate between clinical audit, research and service review activities Janet Brain, Jean Schofield, Kate Gerrish, Sue Mawson, Irene Mabbott, Dipak Patel and Paul Gerrish Sheffield Teaching Hospitals NHS Foundation Trust Clinical audit tool to promote quality for better health services Revised - minor changes to wording - November 2011 Previous versions: September 2009 (first publication) Next review: November 2012 Contents 1 Overview 1 1.1 Introduction 1 1.2 Background 1 1.3 Implications 2 1.4 Purpose of this guide 2 2 The Simple Rules 5 3 The Rule In questions 6 4 Clinical governance and project development 10 4.1 Ethical principles applicable to clinical audit and service review 10 4.1.1 Introduction 10 4.1.2 The ethical principles 10 4.2 Assurance of ethical consideration 13 5 Glossary of terms 16 6 Frequently asked questions about the toolkit 18 References 23 Further reading 24 Tables 1. The Simple Rules 5 2. Rule In question for clinical audit 6 3. Rule In questions for research 7 4. Rule In questions for practice/service development 8 5. Rule In questions for practice/service evaluation 9 6. Ethical principles applicable to clinical audit and service review 11 Appendices Appendix 1. Registration processes 25 Appendix 2. Where to go for help 26 Appendix 3. Example service review confirmation letter for publication or educational purposes 27 Appendix 4. Contributors 29 A Guide for Clinical Audit, Research and Service Review i of 29 1 Overview 1.1 Introduction The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices.
    [Show full text]
  • Clinical Audit - What Is It and How to Do It?
    Miscellany Clinical Audit - What is it and how to do it? Sandhya K Lokuarachchi Consultant Paediatrician, Karapitiya Teaching Hospital, Galle. There is much concern about the quality of care History provided to our patients and the standard of the Monitoring of patient outcomes had been carried care givers. Many instances of national publicity out as early as 1750 BC, during king Hammurabi and criticism regarding patient care in our hospitals of Babylon, with punishments for clinicians for were seen commonly in recent past. Society has poor performance [3]. However, the first clinical become very vigilant and critical about the standard audit is considered to have been carried out by of patient outcomes. Florence Nightingale during the Crimean war of There is no doubt that all attempts should be made 1853-5, when improvement of standards following to give best quality care to our patients. To achieve an “ audit” on cleanliness remarkably reduced the this there should be a systematic way of mortality rates in hospital patients [4]. Ernest identifying the deficiencies honestly with genuine Codman is known as the first true medical auditor attempts at improving the shortcomings. following his work on monitoring surgical outcomes in 1912. Since then process of evaluating patient Clinical audit is the process that supports care remained static for many years. First move continuous quality improvement programmes [1]. to integrate clinical audit in professional health It is one way in which we can work to retain trust care in United Kingdom was the introduction of and respect of patients, in an increasingly critical the white paper, in 1997 [4].
    [Show full text]
  • Significant Event Analysis Guidance for Primary Care Teams Significant Event Analysis Guidance for Primary Care Teams
    Significant Event Analysis Guidance for Primary Care Teams Significant Event Analysis Guidance for Primary Care Teams The development of this Significant Event Analysis guidance was jointly undertaken by NHS Education for Scotland and the National Patient Safety Agency, with support from the Royal College of General Practitioners and Healthcare Improvement Scotland. Authors Paul Bowie PhD Associate Adviser in Postgraduate GP Education NHS Education for Scotland Carl de Wet MRCGP MMed Safety & Improvement Adviser NHS Education for Scotland Michael Pringle MD FRCGP Professor of General Practice University of Nottingham © NHS Education for Scotland 2011. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES. NHS Education for Scotland 1 Contents Foreword........................................................................................................................2 Purpose and background.........................................................................................3 A quick guide to conducting a Significant Event Analysis............................4 A full guide to an effective Significant Event Analysis ..................................6 Stage 1 – Awareness and prioritisation of a significant event................ 10 Stage 2 – Information gathering........................................................................ 11 Stage 3 – The facilitated
    [Show full text]