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Auditing your way to Improvement – in a pandemic?

Our 6 ideas to help change minds of audit doubters
doctors looking at a paper audit on a clip board
| Robert Hobbs | Healthcare

“Audits are paper-pushing check box exercises that consume valuable scarce resource pointless administration.”

“We do them because we have to do them.”

Two unsatisfying comments from stretched staff that feel more resource doing the work is more of a priority than resource auditing the work. Many of us in the safety, quality and improvement field have worked tirelessly to overcome these types of concerns and mindsets for longer than we care to admit!

Feedback is really important. Communicating results to clinical leads and teams, and identifying good news stories for positive media reporting have a major impact.

There is a very genuine concern that disillusioned staff are making. What if the Audits are not making a difference?

Measurement without improvement wastes money and effort.

Here are the top 6 ideas that we have seen to help change the mindset of the remaining doubters in your teams towards audits. Whether we are thinking about wide-scale audits that all staff are completing themselves, like hand hygiene, or we are talking about valuing and supporting professional audit teams completing major national audits, these ideas have helped teams across the country to get better value and results from the audit activity.

No 1. Communication

Make sure you communicate how the content and purpose of the audit are aligned to the goals of the organisation. There is a need to clarify the content and purpose of clinical audits so that staff understand the relevance and importance of the audit and how the audit data can be used to make improvements to services.

No 2. Rewards

Where there are separate doers from the auditors – reward them both for jobs done well! Simple recognition and low-cost tokens of appreciation are all that is required.

For example, for any 100% compliance audit, the ‘doers’ could get hot chocolate and marshmallow tea time treat.

Any non-compliant issue that the auditors find - and is then fixed by an audit action plan cycle – the auditors get the hot chocolate tea time treat!

No 3. League Table

Where you are running the same type of audit in multiple locations, wards, or areas, have an online and pinned-up league table of completion and compliance. Have a monthly, quarterly or 6-monthly champion and announce the winners and create a printed certificate that can be handed out and a notification pinned up on the notice board.

Friendly competition and recognition can work wonders.

No 4. Presentation

Present the results in friendly ways, and then use the ‘we found’ / ‘we did’ approach to communicate the benefit that the audit and its action cycle provided.

‘User-friendly’ output means adopting the principles for good data presentation and reporting formats and styles for a variety of stakeholder audiences. Provide consistent, effective presentation and prompt output.

Delayed and infrequent releases of data are often cited as important barriers to support audits.

No 5. Learning events

Overwhelmingly positive feedback is reported for learning events.

In particular conferences and workshops are often seen as a useful and important way of developing knowledge and skills. Objectives for events include engagement with participants, increasing awareness of audit, disseminating results, discussion and action planning, presenting best practice, an academic or educational component, or a combination of these.

No 6. Joined-up approaches

Joined-up approaches are important. Cynics will easily deride any perceived duplication, onerous data collection, and repetition in types of data requested and these are repeatedly highlighted as issues.

Coordinate the audits and make use of the granular data to create and analyse themes across multiple individual audits. This means you don’t have to ask the same question in multiple audits to get the whole picture.

Consistently structure the governance process. Inconsistencies and variability regarding processes, reporting and subsequent actions taken could be barriers to engagement.

With the pressures on resources caused by COVID-19 Delta and now the ‘double pandemic’ of adding the Omicron strain, we will critically need to ensure that clinical, IPC and safety operating standards do not fall dangerously. Audits help us find out if healthcare is being provided in line with standards and let care providers and patients know where their service is doing well, and where there could be improvements.

The aim is to allow quality improvement to take place where it will be most helpful and will improve outcomes for patients.

Deputy chief nurse for England Duncan Burton encouraged NHS leaders on Tuesday to maximise support from overseas nurses once again. With the arrival of 1,500 international nurses every month since April already, and with this increasing encouragement, there are going to be more staff that will be new to your organisation and processes, making quality checks, audits and compliance increasingly valuable, as long as it can be done efficiently, is properly aligned, engages staff, and audit actions for improvement are well managed.

Robert Hobbs

Chief Executive Officer

InPhase’s Chief Executive and Founder, Robert has been the visionary leading InPhase to be one of the UK's leading providers of management, governance and assurance solutions, and helping organisations align their actions and goals more easily and efficiently with InPhase's suite of integrated apps.

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