We’ve been hearing for a good while now that it is all about quality improvement! Indeed, a few local colleagues have reported to us that senior people in their organisations have been suggesting that clinical audit is now old hat! We’ve even heard horror stories of new QI teams literally being bussed into Trusts on Band 7 salaries with little attempt to conduct partnership working with their clinical audit counterparts mainly on Band 4&5s. The wider narrative appears to be that clinicians are motivated to undertake sexy QI projects, whereas audit is much less interesting and nowhere near as popular.
Now this may all be true… but the stats we have collected from our annual junior doctor competition paints a very different picture. Just to give the background… we set up our junior doctor clinical audit competition in 2010 (with the help of Healthcare Conferences UK) and this generated a great deal of interest. For the first 3 years we continued to run the audit competition, but in 2013 HQIP partnered with us (paying a small sum to help fund the annual finals day) on the insistence that we also ran a QI competition. Before you say… ‘audit is QI so why did you need two competitions’, the simple answer is that ‘not all QI is audit’. To clarify, the projects comparing care to standards were entered into the audit stream and everything else went into the QI melting pot.
As soon as we did this, the constant noises we heard were… ‘you’ll get loads more QI entries than audit entries’…. ‘junior doctors want to do QI not audit’, blah, blah, blah.
2019 marks the tenth anniversary of our competitions (and all the winning posters can be found on our website, plus a few great short films featuring the winners). We’ve had seven years (2013 to 2019) where juniors have been able to enter their hard work into audit and/or QI. And do you know what… EVERY YEAR TO DATE WE HAVE HAD MORE AUDIT ENTRIES THAN QI. And it hasn’t even been close! No Brexit wafer thin majority here… It’s over 60% for audit v less than 40% in favour of QI! And what’s more… we’ll bet a lot of money many of the projects being carried out in your Trust that claim to be QI using multiple PDSA cycles to improve care, are actually measuring against agreed best practice which makes them traditional audits!!! We've had to point this out to quite a few entries we have received from juniors over the years!
Audit and QI are both invaluable. And it is simple... the best consultants of the future (aka juniors now) will value both audit and other QI methodologies.