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Clinical Audit

Clinical audit 

 

EVIDENCE-BASED CARE AND TREATMENT  

Includes, is people’s care, treatment and support achieving good outcomes, promoting a good quality of life and based on the best available evidence? Do staff follow NICE guidelines and JRCALC national guidelines?  

 Looking at where we were before (yesterday), what we are doing currently (today) and what we plan on doing in the future (tomorrow):

 

YESTERDAY  

TODAY  
  • We set a clinical audit programme each year which, as well as the nationally mandated Ambulance Clinical Quality Indicators (ACQIs), also includes audit topics triggered from several sources including NICE guidance and trends from incidents and complaints.   
  • Due to the huge volume of manual data retrieval and input required, we could not complete any local audits last year with all focus applied to meeting NHSE&I requirements for ACQIs. We introduced several 10:10 posters with the aim of reducing the time spent on scene for specific patients such as strokes, STEMIs, and trauma.  

  
  • We currently perform above or in line with the national average for all ACQIs and our time from call to hospital for our stroke patients has been better than the national average for the last six months.  However, we need to improve our compliance for the sepsis care bundle, particularly in relation to documenting hospital pre-alerts. Our audit programme has been enhanced for 2021/22 and added to our Quality Account priorities.  

 

  • We have also recently received ‘Reasonable Assurances’ from our internal auditors regarding our clinical audit processes. 

 

  • Information relating to our clinical audit plan can be found at: Clinical Audit

 

 

TOMORROW  

 

Care bundle indicators have been built in to the new ePCR as mandatory fields with a view to improving compliance. We are working with our IT team to: Transfer data from ePCRs to improve our audit processes and capacity. Introduce Power BI reports for our ACQIs.  

 

PAIN RELIEF  

Includes, how a person’s pain assessed and managed, particularly for those people where there are difficulties in communicating?  

  

YESTERDAY  

TODAY  
  • Outcomes from the STEMI Ambulance Clinical Quality Indicator consistently demonstrates lower levels of compliance for the documentation of 2 pain scores and pain relief. Patient survey responses also show lower levels of satisfaction in relation to pain relief being provided.  

  
  • We have redistributed the care bundles for all ACQIs and will continue to monitor pain relief through the quarterly ACQI process.  

TOMORROW  

Pain relief has been included as a topic within the clinical audit programme for this year and the data retrieval capabilities from ePCR will enable us to run routine audits moving forwards.