Lynn McVey1, Natasha Alvarado1, Justin Keen2, Joanne Greenhalgh3, Mamas Mamas4, Chris Gale5, Patrick Doherty6, Richard Feltbower5, Mai Elshehaly7, Dawn Dowding8, Rebecca Randell9. 1. School of Healthcare, University of Leeds, Leeds, UK. 2. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. 3. School of Sociology and Social Policy, University of Leeds, Leeds, UK. 4. School of Primary, Community and Social Care, Keele University, Keele, UK. 5. School of Medicine, University of Leeds, Leeds, UK. 6. Department of Health Sciences, University of York, York, UK. 7. Faculty of Engineering and Informatics, University of Bradford, Bradford, UK. 8. School of Health Sciences, University of Manchester, Manchester, UK. 9. Faculty of Health Studies, University of Bradford, Bradford, UK.
Abstract
RATIONALE, AIMS, AND OBJECTIVES: Healthcare systems worldwide devote significant resources towards collecting data to support care quality assurance and improvement. In the United Kingdom, National Clinical Audits are intended to contribute to these objectives by providing public reports of data on healthcare treatment and outcomes, but their potential for quality improvement in particular is not realized fully among healthcare providers. Here, we aim to explore this outcome from the perspective of hospital boards and their quality committees: an under-studied area, given the emphasis in previous research on the audits' use by clinical teams. METHODS: We carried out semi-structured, qualitative interviews with 54 staff in different clinical and management settings in five English National Health Service hospitals about their use of NCA data, and the circumstances that supported or constrained such use. We used Framework Analysis to identify themes within their responses. RESULTS: We found that members and officers of hospitals' governing bodies perceived an imbalance between the benefits to their institutions from National Clinical Audits and the substantial resources consumed by participating in them. This led some to question the audits' legitimacy, which could limit scope for improvements based on audit data, proposed by clinical teams. CONCLUSIONS: Measures to enhance the audits' perceived legitimacy could help address these limitations. These include audit suppliers moving from an emphasis on cumulative, retrospective reports to real-time reporting, clearly presenting the "headline" outcomes important to institutional bodies and staff. Measures may also include further negotiation between hospitals, suppliers and their commissioners about the nature and volume of data the latter are expected to collect; wider use by hospitals of routine clinical data to populate audit data fields; and further development of interactive digital technologies to help staff explore and report audit data in meaningful ways.
RATIONALE, AIMS, AND OBJECTIVES: Healthcare systems worldwide devote significant resources towards collecting data to support care quality assurance and improvement. In the United Kingdom, National Clinical Audits are intended to contribute to these objectives by providing public reports of data on healthcare treatment and outcomes, but their potential for quality improvement in particular is not realized fully among healthcare providers. Here, we aim to explore this outcome from the perspective of hospital boards and their quality committees: an under-studied area, given the emphasis in previous research on the audits' use by clinical teams. METHODS: We carried out semi-structured, qualitative interviews with 54 staff in different clinical and management settings in five English National Health Service hospitals about their use of NCA data, and the circumstances that supported or constrained such use. We used Framework Analysis to identify themes within their responses. RESULTS: We found that members and officers of hospitals' governing bodies perceived an imbalance between the benefits to their institutions from National Clinical Audits and the substantial resources consumed by participating in them. This led some to question the audits' legitimacy, which could limit scope for improvements based on audit data, proposed by clinical teams. CONCLUSIONS: Measures to enhance the audits' perceived legitimacy could help address these limitations. These include audit suppliers moving from an emphasis on cumulative, retrospective reports to real-time reporting, clearly presenting the "headline" outcomes important to institutional bodies and staff. Measures may also include further negotiation between hospitals, suppliers and their commissioners about the nature and volume of data the latter are expected to collect; wider use by hospitals of routine clinical data to populate audit data fields; and further development of interactive digital technologies to help staff explore and report audit data in meaningful ways.
Authors: Mellanie V Springer; Anne E Sales; Nishat Islam; A Camille McBride; Zach Landis-Lewis; Michael Tupper; Casey L Corches; Maria Cielito Robles; Lesli E Skolarus Journal: Implement Sci Date: 2021-04-01 Impact factor: 7.327
Authors: Natasha Alvarado; Lynn McVey; Mai Elshehaly; Joanne Greenhalgh; Dawn Dowding; Roy Ruddle; Chris P Gale; Mamas Mamas; Patrick Doherty; Robert West; Richard Feltbower; Rebecca Randell Journal: J Med Internet Res Date: 2021-11-23 Impact factor: 5.428
Authors: Emma Carlin; Zaccariah Cox; Kristen Orazi; Kate L Derry; Pat Dudgeon Journal: Int J Environ Res Public Health Date: 2022-02-03 Impact factor: 3.390