Preparing for audit
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Securing stake-holder interest and involvement (e.g. professionals, patients or carers)
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No
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Selection of appropriate topic, according to whether:
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• Topic concerned is of high cost, volume, or risk to staff or users
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No
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• Evidence of a serious quality problem
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Yes: effects greater if low baseline
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• Good evidence available to inform quality standards
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No
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• Amenability of problem to change
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No
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• Potential for involvement in a national audit project
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No
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• Topic is pertinent to national policy initiatives
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No
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• Topic is a priority for the organisation
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No
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Clear definition of purpose of audit, e.g. to improve or ensure the quality of care
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No
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Provision of necessary support structures, i.e.
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• Structured audit programme (committee structure, feedback mechanisms, and regular audit meetings)
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No
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• Sufficient funding (audit staff, time of clinical staff, data collection, feedback)
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No
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Identification of skills and people needed to carry out the audit
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No
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Selecting criteria
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Definition of criteria (structure, process and outcome)
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No
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Validity and potential to lead to improvements in care
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• Evidence based
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No
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• Related to important aspects of care
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No
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• Measurable
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Yes (implicitly)
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Measuring level of performance
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Planning data collection
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• Definition of user group (and exceptions)
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Can't tell
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• Definition of healthcare professionals involved
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Yes (implicitly)
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• Definition of time period over which criteria apply
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Yes (implicitly)
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Making improvements
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Identification of barriers to change
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No
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Implementing change
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• Establishing the right environment (at individual, team and organisational levels)
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No
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• Considering external relationships (e.g. with patients or other agencies)
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No
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• Use of other supporting interventions (e.g. educational outreach, reminders) and / or multifaceted interventions
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Yes: not supported by evidence
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Sustaining improvement
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Monitoring and evaluating changes, e.g. continuing audit cycle, use of performance indicators
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No
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• Appropriate organisational development (e.g. cultural change, adequate training)
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No
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• Use of existing strategic, organisational or clinical frameworks
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No
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• Leadership
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No
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