Eye on EBVM: 10 top tips on clinical audits

With Clinical Audit Awareness Week taking place from 25 to 29 November, now is a good time to get your team together and discuss how to carry out your own clinical audits in practice.

Clinical audit involves the collection of data for a specific area of practice to understand the level of care you provide and with a view to trying to make that care continuously better. Practices can use the data objectively to see what is working well and what is working less well, and can take steps to repeat actions that lead to better outcomes.

Clinical audit can also encourage good management and maintenance of facilities and equipment, identify where guidelines or protocols need to be updated, and reduce wastage.

vetAUDIT

As a veterinary nurse, you are best placed to instigate clinical auditing in your practice – you can be the one to lead on data gathering and team collaboration. A good place to start is vetAUDIT – the home of the national audit for small animal neutering. vetAUDIT is a free and simple tool allowing anonymous participation to establish the national benchmarks for postoperative complications.

We gathered the following 10 top tips for using vetAUDIT and conducting your own in-practice clinical audits.

1

It’s vital to get the team on board before you start auditing. Be honest about the time and effort required, and try to put aside a small amount of time per week for the team to be involved.

Concentrate on the benefits and insights clinical audits can provide. If some individuals are worried about potential repercussions, emphasise that audits – and quality improvement in general – are about improving patient care, not establishing blame.

2

Involve everyone – the whole team. That way, you will get thoughts, opinions and suggestions from all the team’s perspectives; be able to allocate involvement across the team; and provide real joint ownership of the project.

3

Reassess any existing guidelines you have in place to ensure they are up to date with current evidence. This can be a great project for student veterinary nurses, or any team members wanting to develop their CPD, to get involved in.

4

Standardise your postoperative checks and make sure everyone who will be doing postoperative monitoring, across all your practices, is using the same scoring system. You won’t get useful information if teams are using different criteria.

5

Once you have collected your data, anonymously submitted it to vetAUDIT and compared your results with the national benchmarks, discuss it with the whole team. Different team members may have ideas about what can be improved and how. Plus, bouncing ideas off each other can influence engagement and motivation.

6

If, as a team, you decide to implement any changes, have a discussion about what may or may not need to be done differently. Make sure the changes are realistically achievable and adopted systematically by the whole team.

7

vetAUDIT allows you to benchmark against national statistics and essentially compare your performance to the UK average. But that’s not always the whole story. Once you are some way into auditing, you should also compare your latest results to your previous ones to measure your own improvements. Even if your results are already higher than the national average, you can continuously strive for improvements.

8

Send your team a monthly vetAUDIT results update with some reflective comments in relation to your results. This helps keep your team engaged and maintain the positive changes they have already started.

9

Keep auditing. Quality improvement is a cycle with no fixed end point. After one change has been implemented – and reflected positively or negatively in the results – make additional and/or different changes, and set a date to monitor their impact. Once you’ve reached this point as a practice, quality improvement can become part of your day to day.

10

Finally, celebrate and share your improvements. By providing positive feedback to your team, it gets to see the benefits of taking part and can be proud of its achievements.