Prospective audits offer a way forward for peripatetic locum GPs

by johnpike1

From NASGP blogger John Pike

There has been some anxiety about clinical audit in revalidation for peripatetic locum GPs. However, NASGP recently agreed with Professor Mike Pringle (RCGP lead on revalidation) that prospective audits are acceptable. Simply decide what you will audit, collect data on patients as you see them and then enter the data onto a spreadsheet or Word document when you find time. When you have 10 or more patients, you can summarise the findings (you can tabulate these automatically if you use spreadsheet software) and then start on the second set of data collection. I recently became aware of a few prospective audits that you can do on the web at: http://www.guideline-audit.com. The site has a separate section for sessional GPs. I signed up for the chest infection and asthma exacerbation audits and entered data on the first 3 chest infection patients today. I asked permission from a partner yesterday to do the audit on patients in that particular practice and to print off my consultation records, which I have since shredded after entering data. I got a bit of a shock when I first saw the 5-part data entry form but, in reality, it did not take long to enter the data for each patient. The time was well worth it, since I was immediately able to view tables comparing my performance with other practices globally and the learning has already begun. I will really enjoy doing this audit.

2 Comments to “Prospective audits offer a way forward for peripatetic locum GPs”

  1. I thought you would be interested to see my reflections after completing a full audit cycle on my care of patients with chest infection:

    “The second data collection showed an overall improvement in performance for most indicators compared to the first data collection. Many of the specific improvements in history taking and examination were not apparent from the more general data reported on. However, the improvements took a lot of extra time in the consultation and resulted in my running very late for some surgeries. I do not think that “hard end points” such as improved outcomes for patients have resulted from improvements in history and examination. Nor do I feel that the improvements are sustainable. They increased my stress levels and meant that less time was available for other patients without chest infections. It is hard to justify this, especially since there was probably no material change in outcomes for those patients with chest infection. The net result of the audit was probably to adversely affect care for the majority of patients presenting with other complaints without significantly improving quality of care for those with chest infections. Until such time as consultation times increase to allow for improvements in care, it is hard to justify these particular exercises. Other audits, that result in improvements in care without significantly increasing consultation time, should be performed instead.”

  2. Since finishing the audit, I have tried to put into practice what I learnt on the audit, albeit on a more select group of patients. It has been possible to do that without running significantly late. I think it has been a useful educational experience after all.

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