Wessex Acute Frailty Audit: applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach
Wessex Acute Frailty Audit: applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach
Introduction: An acute hospital stay increases the risk of negative outcomes for those living with frailty. This paper describes the application of quality improvement methodology to design and implement a regional audit to gain an understanding of care provision.
Methods: Small scale tests of change (Plan–Do–Study–Act cycles) were used to design the audit structure and questions. Data collectors met face to face with 2–3 multiprofessional clinicians on 58 wards in 10 hospitals across the region, using an electronic tool to gather data. Outcomes were analysed manually in Excel by extracting from the electronic audit tool.
Results: 58 wards across 10 hospitals participated in the audit, which identified three key themes: lack of awareness and frailty training outside medicine for older people specialties, and significant variability of both frailty identification and comprehensive geriatric assessment.
Conclusion: Combining quality improvement methodology with a collaborative, regional approach to design and implementation of a frailty audit creates a reliable tool ensuring all stakeholders are considering improvement from the outset. The results have facilitated an agreed regional approach on how best to use local resources to improve and standardise frailty care provision. By highlighting areas of good practice and significant gaps in frailty identification, personalised care planning and hospital wide provision of frailty training, this region of the UK will now be able to drive up standards of care.
PDSA, clinical audit, healthcare quality improvement, patient-centred care, quality improvement methodologies
Lewis, Lucy Anne
3d79b53a-8499-4916-9a9d-17032ae19dc9
Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Burrows, Kerry
2c58f5dd-a87a-460c-a41f-c93962d15b9f
Spice, Claire
57e1f75d-297d-43dc-80c6-2002a045d102
Davies, Cheryl
aef93724-689c-4b63-be8b-57492eda83c7
Wallis, Kathy
89f0afa3-3f12-4cc4-8a73-4d5b0dbabf1e
3 February 2020
Lewis, Lucy Anne
3d79b53a-8499-4916-9a9d-17032ae19dc9
Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Burrows, Kerry
2c58f5dd-a87a-460c-a41f-c93962d15b9f
Spice, Claire
57e1f75d-297d-43dc-80c6-2002a045d102
Davies, Cheryl
aef93724-689c-4b63-be8b-57492eda83c7
Wallis, Kathy
89f0afa3-3f12-4cc4-8a73-4d5b0dbabf1e
Lewis, Lucy Anne, Corbett, Teresa, Burrows, Kerry, Spice, Claire, Davies, Cheryl and Wallis, Kathy
(2020)
Wessex Acute Frailty Audit: applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach.
BMJ Open Quality, 9 (1), [e000870].
(doi:10.1136/bmjoq-2019-000870).
Abstract
Introduction: An acute hospital stay increases the risk of negative outcomes for those living with frailty. This paper describes the application of quality improvement methodology to design and implement a regional audit to gain an understanding of care provision.
Methods: Small scale tests of change (Plan–Do–Study–Act cycles) were used to design the audit structure and questions. Data collectors met face to face with 2–3 multiprofessional clinicians on 58 wards in 10 hospitals across the region, using an electronic tool to gather data. Outcomes were analysed manually in Excel by extracting from the electronic audit tool.
Results: 58 wards across 10 hospitals participated in the audit, which identified three key themes: lack of awareness and frailty training outside medicine for older people specialties, and significant variability of both frailty identification and comprehensive geriatric assessment.
Conclusion: Combining quality improvement methodology with a collaborative, regional approach to design and implementation of a frailty audit creates a reliable tool ensuring all stakeholders are considering improvement from the outset. The results have facilitated an agreed regional approach on how best to use local resources to improve and standardise frailty care provision. By highlighting areas of good practice and significant gaps in frailty identification, personalised care planning and hospital wide provision of frailty training, this region of the UK will now be able to drive up standards of care.
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Wessex Acute Frailty Audit applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach
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Accepted/In Press date: 14 January 2020
e-pub ahead of print date: 3 February 2020
Published date: 3 February 2020
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© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords:
PDSA, clinical audit, healthcare quality improvement, patient-centred care, quality improvement methodologies
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Local EPrints ID: 437920
URI: http://eprints.soton.ac.uk/id/eprint/437920
PURE UUID: b2f701fa-3c3e-41a1-8a0d-3fdd95c694bc
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Date deposited: 24 Feb 2020 17:30
Last modified: 06 Jun 2024 01:55
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Contributors
Author:
Lucy Anne Lewis
Author:
Teresa Corbett
Author:
Kerry Burrows
Author:
Claire Spice
Author:
Cheryl Davies
Author:
Kathy Wallis
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