A scoping review of local quality improvement using data from UK perioperative National Clinical Audits
Abstract Background Significant resources are invested in the UK to collect data for National Clinical Audits (NCAs), but it is unclear whether and how they facilitate local quality improvement (QI). The perioperative setting is a unique context for QI due to its multidisciplinary nature and history...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | Perioperative Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13741-022-00273-0 |
| _version_ | 1798004313355714560 |
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| author | Duncan Wagstaff Samantha Warnakulasuriya Georgina Singleton Suneetha Ramani Moonesinghe Naomi Fulop Cecilia Vindrola-Padros |
| author_facet | Duncan Wagstaff Samantha Warnakulasuriya Georgina Singleton Suneetha Ramani Moonesinghe Naomi Fulop Cecilia Vindrola-Padros |
| author_sort | Duncan Wagstaff |
| collection | DOAJ |
| description | Abstract Background Significant resources are invested in the UK to collect data for National Clinical Audits (NCAs), but it is unclear whether and how they facilitate local quality improvement (QI). The perioperative setting is a unique context for QI due to its multidisciplinary nature and history of measurement. It is unclear which NCAs evaluate perioperative care, to what extent their data have been used for QI, and which factors influence this usage. Methods NCAs were identified from the directories held by Healthcare Quality Improvement Partnership (HQIP), Scottish Healthcare Audits and the Welsh National Clinical Audit and Outcome Review Advisory Committee. QI reports were identified by the following: systematically searching MEDLINE, CINAHL Plus, Web of Science, Embase, Google Scholar and HMIC up to December 2019, hand-searching grey literature and consulting relevant stakeholders. We charted features describing both the NCAs and the QI reports and summarised quantitative data using descriptive statistics and qualitative themes using framework analysis. Results We identified 36 perioperative NCAs in the UK and 209 reports of local QI which used data from 19 (73%) of these NCAs. Six (17%) NCAs contributed 185 (89%) of these reports. Only one NCA had a registry of local QI projects. The QI reports were mostly brief, unstructured, often published by NCAs themselves and likely subject to significant reporting bias. Factors reported to influence local QI included the following: perceived data validity, measurement of clinical processes as well as outcomes, timely feedback, financial incentives, sharing of best practice, local improvement capabilities and time constraints of clinicians. Conclusions There is limited public reporting of UK perioperative NCA data for local QI, despite evidence of improvement of most NCA metrics at the national level. It is therefore unclear how these improvements are being made, and it is likely that opportunities are being missed to share learning between local sites. We make recommendations for how NCAs could better support the conduct, evaluation and reporting of local QI and suggest topics which future research should investigate. Trial registration The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018092993 ). |
| first_indexed | 2024-04-11T12:21:30Z |
| format | Article |
| id | doaj.art-79242a668cb04fc8bafd2e29e8068151 |
| institution | Directory Open Access Journal |
| issn | 2047-0525 |
| language | English |
| last_indexed | 2024-04-11T12:21:30Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj.art-79242a668cb04fc8bafd2e29e80681512022-12-22T04:24:05ZengBMCPerioperative Medicine2047-05252022-08-0111111110.1186/s13741-022-00273-0A scoping review of local quality improvement using data from UK perioperative National Clinical AuditsDuncan Wagstaff0Samantha Warnakulasuriya1Georgina Singleton2Suneetha Ramani Moonesinghe3Naomi Fulop4Cecilia Vindrola-Padros5Department of Anaesthesia, University College London HospitalDepartment of Anaesthesia, University College London HospitalPQIP, National Institute of Academic Anaesthesia Health Services Research Centre, Royal College of AnaesthetistsDepartment of Anaesthesia, University College London HospitalDepartment of Applied Health Research, University College LondonDivision of Surgery and Targeted Intervention, University College LondonAbstract Background Significant resources are invested in the UK to collect data for National Clinical Audits (NCAs), but it is unclear whether and how they facilitate local quality improvement (QI). The perioperative setting is a unique context for QI due to its multidisciplinary nature and history of measurement. It is unclear which NCAs evaluate perioperative care, to what extent their data have been used for QI, and which factors influence this usage. Methods NCAs were identified from the directories held by Healthcare Quality Improvement Partnership (HQIP), Scottish Healthcare Audits and the Welsh National Clinical Audit and Outcome Review Advisory Committee. QI reports were identified by the following: systematically searching MEDLINE, CINAHL Plus, Web of Science, Embase, Google Scholar and HMIC up to December 2019, hand-searching grey literature and consulting relevant stakeholders. We charted features describing both the NCAs and the QI reports and summarised quantitative data using descriptive statistics and qualitative themes using framework analysis. Results We identified 36 perioperative NCAs in the UK and 209 reports of local QI which used data from 19 (73%) of these NCAs. Six (17%) NCAs contributed 185 (89%) of these reports. Only one NCA had a registry of local QI projects. The QI reports were mostly brief, unstructured, often published by NCAs themselves and likely subject to significant reporting bias. Factors reported to influence local QI included the following: perceived data validity, measurement of clinical processes as well as outcomes, timely feedback, financial incentives, sharing of best practice, local improvement capabilities and time constraints of clinicians. Conclusions There is limited public reporting of UK perioperative NCA data for local QI, despite evidence of improvement of most NCA metrics at the national level. It is therefore unclear how these improvements are being made, and it is likely that opportunities are being missed to share learning between local sites. We make recommendations for how NCAs could better support the conduct, evaluation and reporting of local QI and suggest topics which future research should investigate. Trial registration The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018092993 ).https://doi.org/10.1186/s13741-022-00273-0Quality improvementClinical auditPerioperative medicineAnaesthesiaSurgery |
| spellingShingle | Duncan Wagstaff Samantha Warnakulasuriya Georgina Singleton Suneetha Ramani Moonesinghe Naomi Fulop Cecilia Vindrola-Padros A scoping review of local quality improvement using data from UK perioperative National Clinical Audits Perioperative Medicine Quality improvement Clinical audit Perioperative medicine Anaesthesia Surgery |
| title | A scoping review of local quality improvement using data from UK perioperative National Clinical Audits |
| title_full | A scoping review of local quality improvement using data from UK perioperative National Clinical Audits |
| title_fullStr | A scoping review of local quality improvement using data from UK perioperative National Clinical Audits |
| title_full_unstemmed | A scoping review of local quality improvement using data from UK perioperative National Clinical Audits |
| title_short | A scoping review of local quality improvement using data from UK perioperative National Clinical Audits |
| title_sort | scoping review of local quality improvement using data from uk perioperative national clinical audits |
| topic | Quality improvement Clinical audit Perioperative medicine Anaesthesia Surgery |
| url | https://doi.org/10.1186/s13741-022-00273-0 |
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