In Solent, every Service Line has an annual audit and evaluation plan which ties in with the Trust-wide plan. These include audits and evaluations that have been identified as priorities by the services within it, and those that we are required to do as part of our Quality Contract with commissioners or the National Audit programme.
Service lines manage and oversee their own programmes, with the support of the Improvement team. This is a successful model, but as we continue to mature and learn, we thought we’d share some of the elements of really successful programmes.
From working with services across Solent, we’ve picked these helpful tips for running an audit programme:
1. Make sure you have clear roles and responsibilities across your teams
Do you have a reliable staff structure and processes in place across your services for creating and monitoring your audit and evaluation plan?
It’s important to have a structure in place so that communication about how audits are progressing, and the learning from them is shared. We find this works better when roles are clearly defined and there is an up-to-date network/structure for communication in place.
2. Regularly connect to plan and review projects and progress
Do you have a process for meeting to discuss how projects are going, what the findings are and what changes may be needed?
Once you have your structure and networks in place it’s important that you meet regularly to review the work you have done. This helps to share the workload, support teams, and make sure that the learning is being shared across the service line and beyond. These meetings should also include findings from national audits and NICE guideline updates.
Having a way to connect regularly can also serve as a forum to link data relating to incidents, patient experience, and other information that can be used to set future priorities for audits or evaluations.
3. Involve patients, carers, staff and partner organisations
Do you consult and involve staff, patients and partner organisations when you are planning and reviewing audits and evaluations?
We are very keen to avoid making decisions about (or for) other people. It is not good practice to audit someone else’s work and then telling them what they should do better, and it is especially important that we don’t second guess what is important to patients. Ideally, we would like to see patients and the public fully engaged in selecting and designing the audits and evaluations we conduct; putting the patient voice at the heart of the activity.
4. Check that you actions are leading to improvement
Do you track and chase planned actions for improvement from previous audits (before you re-audit)? And do you check whether these actions or changes are actually leading to an improvement?
Audits and service evaluations are quality improvement tools, not just performance measures. The cycle of measurement, actions for improvement and re-measurement should be continuous. It’s also easy to fall into the trap of doing lots of actions, without them making much of a difference.
So, keep an eye on what changes are being made with the actions and don’t be afraid to abandon changes that aren’t working.
5. Sharing learning from improvement
Do you share learning and improvement from your audits and evaluations across your services? How well does this work?
A culture of cross-team learning is one of the hallmarks of an excellent organisation. Equally, when an organisation invests time in audits and evaluations, there should be processes in place for sharing the learning across teams and service lines. It could be the case that a service looking for a solution to poor performance or compliance, may not be the only one in the organisation. So, when a service has demonstrated improvement, we should be sharing that learning as widely as possible to ensure that our teams are as informed as they can be. This also helps to acknowledge and appreciate all of the work that has gone into conducting the audit and writing up the results. It’s the fun part.
There are a number of ways that services can share their learning, including: case studies, blogs, and coming along to Learning and Improvement events.
If you’d like more information about sharing learning or audit in general, please email the improvement team who will be happy to discuss any ideas or obstacles you have.