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Sample Clinical audit Stages example.pptx
A clinical audit was conducted at St. Peter Specialized Hospital focusing on hypertension management, identifying key stakeholders and collecting data to improve care outcomes. Major gaps highlighted included a lack of standard protocols, poor understanding of treatment guidelines, and inadequate patient follow-up. The audit aimed to increase the percentage of patients with controlled hypertension from 52% to 80% by December 2019 through various quality improvement measures.
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Sample Clinical audit Stages example.pptx
- 1. CLINICAL AUDIT CONDUCTED ONNCD EXAMPLE
- 2. STAGE 1. PLANNING Identifying stakeholder Stake holders for this audit OPD Director OPD case manager Internist Chief resident GP head nurse Clinical pharmacist Quality focal Team was established from the above mentioned disciplines and leadership
- 3. PLANNING CONT’D …. AuditTopic Data was collected from the HMIS to determine the top cause of Morbidity and mortality at the hospital. These include in descending order HTN DM and cardiac diseases were selected based on the data HTN selected for audit in the first cycle
- 4. PLANNING CONT’D …. Audit field work Objective of the audit cycle Determining major Gaps in HTN care and treatment Propose alternative change ideas for the identified gaps To plan and execute QI plan Retrospective Chart audit and client interview were selected as a methodology for the audit Action plan was developed
- 5. PLANNING CONT’D …. NoActivity Responsible Body Timeline 1 Determining the sample size and method of sampling The team Aug. 6, 2019 2 Identifying samples and chart retrieval OPD Director and case manager, head nurse Aug 7 , 2019 3 Conducting the audit Internist- consultation Resident, GP, intern, clinical pharmacist Aug 8-13, 2019 4 Presentation of findings on the morning session and discussion Resident Aug 14, 2019 5 Design a QI plan based on the findings Quality focal- lead Discussion on the team Aug 14-17, 2019 6 Executing the change idea and follow-up Staffs, OPD director, case managers, head nurse and Quality focal For the determined period stated on the aim of the QI project / 3 months 7 Re- audit The audit team After 3 months
- 6. STAGE 2. STANDARD& CRITERIA SELECTION The team decided to utilize the standards stated on the HSTQ NCD standards Standard 1 to 6
- 7. STAGE-3: MEASURING PERFORMANCES Data collection Data source :- patient chart, client interview Method :- retrospective chart review , prospective client interview Sample selection :- Systematic random sampling was used to select patient record number from the Appointment log book Sample size 19 charts were selected Data collection tool Checklist stated on the HSTQ was utilized to collect data
- 8. STAGE-3: MEASURING PERFORMANCESCONT’D…… Data Analysis :- Excel was used for the data entry Standard Checklist Weight MRN 1 MRN 2 ---19 Average score NCD6.1The health facility has a hypertension management protocol and maintains competency of HCWs The health facility has written, up-to-date, clinical protocols for management of hypertension (can be endorsed/customized National STG) 1 Health-care staff in the facility receive in- service training or regular refresher sessions 1 NCD6.3 Diagnosis of Hypertension is made based on standard criteria and all evidences are documented in legible handwriting Diagnosis is based on repeated BP measurements 10 stage of HTN and Cardiovascular risk stratification is documented (See annexed HTN classification and Risk Stratification criteria.) 10 On entry into care a newly diagnosed patient with hypertension should be assessed using relevant history, focused physical exam 10
- 9. STAGE-3: MEASURING PERFORMANCESCONT’D…… NCD6.1 hypertension management protocol a NCD6.2 routinely screened NCD6.3 Diagnosis of Hypertension NCD6.4 Evidence based management plan and follow up scheme is outlined for all hypertensive patients NCD6.5 controlled BP 52.60% 57.89% 89.00% 26.30% 42.00% HTN management
- 10. STAGE-3: MEASURING PERFORMANCESCONT’D…… Drawing Conclusion Major gaps identified during the audit were Lack of standardized protocol poor control of HTN Underperformance screening of NCD complication Thorough evaluation and documentation of patient Hx appointment and patient tracing mechanism Health education is not regularly given Interruption of basic Ix modalities Report Writing and Presenting Results Results were presented on the morning session
- 11. STAGE 4. LINKINGCLINICAL AUDIT FINDINGS WITH QUALITY IMPROVEMENT Title: Improving HTN control in St. Peter Specialized Hospital Aim statement:- The SPSH OPD QI team aims to improve patients who has control HTN from 52% To 80 % by the end of Dec 2019.
- 12. To improve patients whohas control HTN from 52% to 80 % People System/process Supplies Poor engagement of senior physicians Knowledge and skill gap Infrastructure Introducing EMR system in the chronic clinic Lack of adequate clinics for chronic follow-up Patient appointment was not well documented an d tracing Poor recording keeping -Regular trainings and awareness creation Some Equipment’s, drugs and supplies not available Interruption of Ix Introducing scope based practice Task shifting to cluster health centers Implementing PPP Implementing the IPLS Managing appointment system electronically Treatment guideline not readily available Starting patient tracing Preparing locally developed treatment guideline for common disease Lack of regular health education for patients Implementing regular H/E program with scheduling Conducting a regular re-audits and feedback for chronic clinic Clinical audits are not regularly done for learning
- 13. Measures Outcome measure Percentof patient with good HTN control Process measures Proportion of patients adhered to appointment date No of health education session conducted No of mentorship and feedback session No of patients referred out to catchment H/C Balancing measure Patient waiting time to treatment
- 14. No Plan ResponsibleBody Timeline Remark 1 Orienting the QIT QI focal personnel Every month 2 Hold discussions internist to have a standard protocol QI focal personnel End of meskerem 3 Avail monitoring and screening equipment’s at st peter tikimit 4. Hold mettings with cluster health centrs QI focal personnel Every month 5. Start a linkage system with health center with monitoring schedule QI focal person Every month
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