Let's celebrate our NHS audit and QI heroes!

Apologies again for the slight delay in publishing this latest blog. When we set up this QI blog last Summer the plan was to blog weekly. Lately we have slipped to every fortnight, but rest assured during the coronavirus pandemic we are determined to get back to publishing on a weekly basis. Who knows, maybe more often than that!

First of all, we’d just like to pass on our best wishes and a virtual hug to everyone out there working in a healthcare setting, whether that be NHS staff or not. All of you, bar none, are true heroes. We all now know that we are in the mother of all battles and this is a defining moment for our country and the world. Thank you to everyone who is following the national and international guidance to combat the spread of this disease.

To talk about the importance of quality improvement and clinical audit at times like these seems somewhat trivial in the circumstance. However, the truth is, clinical audit and quality improvement teams actually have a MASSIVE part to play at the current time.

Already we have seen evidence via BBC News (see below) that national clinical audit is being used to find out more about the onset and spread of COVID-19. The intelligent folks at the Intensive Care National Audit and Research Centre (ICNARC) took audit data on 196 patients to better understand the spread and impact of coronavirus. This is vital work and we look forward to seeing more detailed studies from ICNARC in coming days and weeks. You can read their report via this link.

We also note QI techniques are being used globally to plot the onset of the disease and predict the impact in the future. Many of you will have seen charts like the one below, showing how COVID-19 has progressed in various countries. In effect, these use a well-known tool in the QI Facilitators toolbox, the humble run chart. Expect to see more of these at global, international, regional and local level in coming weeks.

Of course, we all know clinical audit finds out if we are doing what we know we should be doing. Therefore, audit has a vital role to play in combating COVID-19. Are the population following best practice and observing the social distancing rules? Are we washing our hands regularly and for a minimum of 20 seconds (as per the guidance)? Are those who can work from home, following this guidance. Within the NHS we’d expect lots of organisational audits to be in operation soon… with the World Health Organisation offering increasing levels of guidance, e.g. in relation to testing patients and protective clothing for staff managing suspected COVID-19 patients, this will be a busy time for audit teams.

And we already know that audit and QI teams are already playing a massive role in all this. Last week we noted the tweet from Jordan Thompson up in the North East (see below). This highlights the fact that across the NHS, audit staff are being redeployed to help combat the spread of coronavirus. We know from looking at other social media that this happening in lots of hospitals and NHS organisations. And with that in mind, we’d love to hear from any audit and QI staff who would want to tell us about what they are doing at the moment. We’d love to share your stories with others and help keep spirits up. If you have time to write us a guest blog (ideally 300-500 words) then that would be amazing, but in such times, we’ll consider mini blogs (100-200 words). Just tell us what you are up to! And if you can’t blog then hook us in via social media and our @cascleicester twitter handle. We’ll be sure to re-tweet the exceptional efforts you are putting in!

On a final note, it is important to pass on this message from HQIP that was released very late last week. The 4-page letter is essential reading for all staff working in clinical audit and quality improvement. The key statement from NHS England and the Welsh Government is ‘all national clinical audit, confidential enquiries and national joint registry data collection, including for VTE risk assessment, should be suspended’. The Clinical Audit Support Centre fully support this common-sense and much needed decision. To read the letter in full, click here.