Guidance in the Unlocking the potential report has been produced to increase the engagement of doctors in quality improvement activity through greater accessibility to the outputs of national clinical audit (NCA).
- Sufficient training and resources need to be put in place to support quality improvement activity.
- Stronger educational and organisational infrastructure for trainee doctors is vital in promoting the benefits of NCA data, and in supporting doctors to use the data.
- Doctors should be provided with enough mentoring, time and space to be allowed to access and use data to drive improvements in care.
- Developing quality improvement skills in higher specialty trainees would benefit from combining a regional approach to quality improvement education and training, underpinned by local organisational support involving multidisciplinary teams.
Clinical audit has a dual role, which has led to potential confusion. Its first role is as a quality assurance process and the second is as a quality improvement process. However, by focusing on quality assurance, small adjustments in practice are made to conform to standards rather than taking every opportunity to improve care.
The perception of clinical audit therefore needs to shift from an emphasis on data collection to ensuring it is used as a tool for continuous improvement.
Different models of implementation of improvement learning were tested with seven different medical specialties involving a number of higher speciality trainees. It used the outputs of NCA as the catalyst for improvement while the trainees were supported to learn about quality improvement in action.