Abstract
Rationale, aims and objectives: Healthcare systems worldwide devote significant
resources towards collecting data to support care quality assurance and
improvement. In the United Kingdom, National Clinical Audits are intended to
contribute to these objectives by providing public reports of data on healthcare
treatment and outcomes, but their potential for quality improvement in particular is
not realised fully among healthcare providers. Here, we aim to explore this
outcome from the perspective of hospital boards and their quality committees: an
under-studied area, given the emphasis in previous research on the audits’ use by
clinical teams.
Methods: We carried out semi-structured, qualitative interviews with 54 staff in
different clinical and management settings in five English National Health Service
hospitals about their use of NCA data, and the circumstances that supported or
constrained such use. We used Framework Analysis to identify themes within their
responses.
Results: We found that members and officers of hospitals’ governing bodies
perceived an imbalance between the benefits to their institutions from National
Clinical Audits and the substantial resources consumed by participating in them.
This led some to question the audits’ legitimacy, which could limit scope for
improvements based on audit data, proposed by clinical teams.
Conclusions: Measures to enhance the audits’ perceived legitimacy could help
address these limitations. These include audit suppliers moving from an emphasis
on cumulative, retrospective reports to real-time reporting, clearly presenting the
‘headline’ outcomes important to institutional bodies and staff. Measures may also
include further negotiation between hospitals, suppliers and their commissioners
about the nature and volume of data the latter are expected to collect; wider use by
hospitals of routine clinical data to populate audit data fields; and further
development of interactive digital technologies to help staff explore and report audit
data in meaningful ways.
resources towards collecting data to support care quality assurance and
improvement. In the United Kingdom, National Clinical Audits are intended to
contribute to these objectives by providing public reports of data on healthcare
treatment and outcomes, but their potential for quality improvement in particular is
not realised fully among healthcare providers. Here, we aim to explore this
outcome from the perspective of hospital boards and their quality committees: an
under-studied area, given the emphasis in previous research on the audits’ use by
clinical teams.
Methods: We carried out semi-structured, qualitative interviews with 54 staff in
different clinical and management settings in five English National Health Service
hospitals about their use of NCA data, and the circumstances that supported or
constrained such use. We used Framework Analysis to identify themes within their
responses.
Results: We found that members and officers of hospitals’ governing bodies
perceived an imbalance between the benefits to their institutions from National
Clinical Audits and the substantial resources consumed by participating in them.
This led some to question the audits’ legitimacy, which could limit scope for
improvements based on audit data, proposed by clinical teams.
Conclusions: Measures to enhance the audits’ perceived legitimacy could help
address these limitations. These include audit suppliers moving from an emphasis
on cumulative, retrospective reports to real-time reporting, clearly presenting the
‘headline’ outcomes important to institutional bodies and staff. Measures may also
include further negotiation between hospitals, suppliers and their commissioners
about the nature and volume of data the latter are expected to collect; wider use by
hospitals of routine clinical data to populate audit data fields; and further
development of interactive digital technologies to help staff explore and report audit
data in meaningful ways.
| Original language | English |
|---|---|
| Journal | Journal of Evaluation in Clinical Practice |
| Publication status | Accepted/In press - 1 Apr 2020 |