scholarly journals Embedding EBVM into Practice

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Bradley Viner
Keyword(s):  
Open Access ◽  
Patient Care ◽  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Best Practice ◽  
Clinical Performance ◽  
Clinical Audit ◽  
Clinical Effectiveness ◽  
Pros And Cons ◽  
Audit Cycle

<p>Embracing EBVM as a concept is an important first step, but is of little value unless it is translated into an improvement in patient care. This session will discuss how EBVM can be incorporated into clinical guidelines at a practice level, using a team-based approach to maximise concordance. The pros and cons of using practice guidelines as a means of improving clinical effectiveness will be discussed, followed by an illustration of how the clinical audit cycle can be used as a tool to ensure that Best Practice as a established by practice guidelines is applied to produce an improvement in clinical performance.</p><p> <a href="/index.php/ve/article/view/95/128"><img src="/public/site/images/bridget/Bradley_twitte_image.PNG" alt="" /></a></p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" />

scholarly journals Aphasia Rehabilitation Service Delivery in a Stroke Rehabilitation Unit in Australia: A Clinical Audit of Speech Pathology Practices

2016 ◽  
Author(s):  
Laleh Rej ◽  
Sebastian Doeltgen ◽  
Amy Rodriguez ◽  
Willem van Steenbrugge
Keyword(s):  
Service Delivery ◽  
Clinical Guidelines ◽  
Stroke Rehabilitation ◽  
Best Practice ◽  
Clinical Audit ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Speech Pathology ◽  
Rehabilitation Unit ◽  
Retrospective Audit

Purpose: To investigate service delivery of aphasia rehabilitation in a metropolitan rehabilitation hospital by speech pathologists and assess adherence to both the National Stroke Foundation (NSF) Clinical Guidelines and the Australasian Rehabilitation Outcomes Centre (AROC) database of benchmarks. Method: A retrospective audit of 34 discharged patients was conducted within a dedicated stroke rehabilitation unit from March 2012 to July 2013 in Australia. Discharge reports, Functional Independence Measure (FIM) scores and clinical time statistics derived from the organization’s electronic database were studied and compared with NSF’s Clinical Guidelines for best practice recommendations and AROC benchmarks. Results: Patients with aphasia were admitted to inpatient rehabilitation at an average of 21 days post stroke, 2 days beyond the AROC benchmark for inpatient rehabilitation. The mean length of stay of patients with aphasia was 60 days, significantly longer than the average AROC benchmark of 32.8 days. Patients received an average of 4.25 hours of speech pathology therapy per week, more than twice the minimum amount of therapy time recommended by the NSF Guidelines. Conclusion: The current clinical audit is the first known speech pathology audit investigating adherence to stroke and aphasia rehabilitation guidelines set forth by the NSF clinical guidelines and AROC benchmarks in Australia. By comparing current care with advocated best practice, strengths were identified in service delivery, as well as priority areas for quality improvement.

Quality assurance and quality improvement in medical practice – Part 3. Clinical audit in medical practice

2012 ◽  
Vol 153 (5) ◽  
pp. 174-183 ◽  
Author(s):  
Sándor Gődény
Keyword(s):  
Quality Assurance ◽  
Quality Improvement ◽  
Medical Practice ◽  
Best Practice ◽  
Clinical Audit ◽  
Clinical Effectiveness ◽  
Service Improvement ◽  
Quality Improvement Process ◽  
Quality Improvement Interventions ◽  
Definition Of

The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised. Orv. Hetil., 2012, 153, 174–183.

Clinical Audit in Emergency Medicine

2003 ◽  
Vol 10 (3) ◽  
pp. 181-187 ◽  
Author(s):  
CH Chung
Keyword(s):  
Emergency Medicine ◽  
Quality Improvement ◽  
Healthcare Professionals ◽  
Medical Literature ◽  
Clinical Performance ◽  
Clinical Audit ◽  
Clinical Care ◽  
Emergency Physicians ◽  
Cyclical Process ◽  
Audit Cycle

Clinical audit is the review of clinical performance against agreed standards, and the refining of clinical practice as a result – a cyclical process of quality improvement in clinical care. The different steps of the clinical audit cycle are discussed. Publications on clinical audit in connection with Emergency Medicine are scarce in the medical literature. Clinical audit should be made compulsory for all healthcare professionals providing clinical care, and emergency physicians are no exceptions.

scholarly journals Audit of Orthopaedic Audits in an English Teaching Hospital: Are We Closing the Loop?

2010 ◽  
Vol 4 (1) ◽  
pp. 188-192 ◽  
Author(s):  
H.J Iqbal ◽  
P Pidikiti
Keyword(s):  
Patient Care ◽  
Teaching Hospital ◽  
Clinical Audit ◽  
Healthcare Delivery ◽  
Significant Proportion ◽  
Improve Patient Care ◽  
Junior Doctors ◽  
Active Involvement ◽  
Closing The Loop ◽  
Audit Cycle

Background: Clinical audit is an important tool to improve patient care and outcomes in health service. A significant proportion of time and economic resources are spent on activities related to clinical audit. Completion of audit cycle is essential to confirm the improvements in healthcare delivery. We aimed this study to evaluate audits carried out within trauma and orthopaedic unit of a teaching hospital over the last 4 years, and establish the proportions which were re-audited as per recommendations. Methods: Data was collected from records of the clinical audit department. All orthopaedic audit projects from 2005 to 2009 were included in this study. The projects were divided in to local, regional and national audits. Data regarding audit lead clinicians, completion and presentation of projects, recommendations and re-audits was recorded. Results: Out of 61 audits commenced during last four years, 19.7% (12) were abandoned, 72.1% (44) were presented and 8.2 % (5) were still ongoing. The audit cycle was completed in only 29% (13) projects. Conclusion: Change of junior doctors every 4~6 months is related to fewer re-audits. Active involvement by supervising consultant, reallocation of the project after one trainee has finished, and full support of audit department may increase the ratio of completion of audit cycles, thereby improving the patient care.

scholarly journals Clinical Guidelines, the Politics of Value, and the Practice of Medicine: Physicians at the Crossroads

2012 ◽  
Vol 8 (4) ◽  
pp. 233-235 ◽  
Author(s):  
Richard A. Cooper ◽  
David J. Straus
Keyword(s):  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Best Practice ◽  
Level Of Care ◽  
Best Practice Guidelines ◽  
Practice Of Medicine ◽  
Pathways Of Care

Best practice guidelines are being used to an increasing degree, not only by physicians to improve the level of care, but also by bureaucrats to constrain reimbursement and guide the pathways of care.

IMPROVEMENT OF THE PATIENT CARE PROCESS BASED ON THE PRINCIPLES OF CLINICAL AUDIT

2020 ◽  
Vol 16 (72) ◽  
pp. 027
Author(s):  
А.О. Gavrilyuk ◽  
R.G. Zharlinska ◽  
А.А. Mishchuk ◽  
К.М. Vergeles ◽  
А.М. Berezovskyi ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Audit ◽  
Care Process ◽  
Patient Care Process

The use of the objective structured clinical examination (OSCE) in a practice-based health discipline: Academic and student experience in paramedicine

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Andy Bell ◽  
Jennifer Kelly ◽  
Peter Lewis
Keyword(s):  
Clinical Examination ◽  
Best Practice ◽  
Assessment Tool ◽  
Clinical Performance ◽  
Reliability And Validity ◽  
Specific Area ◽  
Training Model ◽  
Objective Structured Clinical Examination ◽  
Evidence Based ◽  
Effective Measure

Abstract:Purpose:Over the past two decades, the discipline of Paramedicine has seen expediential growth as it moved from a work-based training model to that of an autonomous profession grounded in academia.  With limited evidence-based literature examining assessment in paramedicine, this paper aims to describe student and academic views on the preference for OSCE as an assessment modality, the sufficiency of pre-OSCE instruction, and whether or not OSCE performance is a perceived indicator of clinical performance.Design/Methods:A voluntary, anonymous survey was conducted to examine the perception of the reliability and validity of the Objective Structured Clinical Examination (OSCE) as an assessment tool by students sitting the examination and the academics that facilitate the assessment. Findings:The results of this study revealed that the more confident the students are in the reliability and validity of the assessment, the more likely they are to perceive the assessment as an effective measure of their clinical performance.  The perception of reliability and validity differs when acted upon by additional variables, with the level of anxiety associated with the assessment and the adequacy of feedback of performance cited as major influencers. Research Implications:The findings from this study indicate the need for further paramedicine discipline specific research into assessment methodologies to determine best practice models for high quality assessment.Practical Implications:The development of evidence based best practice guidelines for the assessment of student paramedics should be of the upmost importance to a young, developing profession such as paramedicine.Originality/Value: There is very little research in the discipline specific area of assessment for paramedicine and discipline specific education research is essential for professional growth.Limitations:The principal researcher was a faculty member of one of the institutions surveyed.  However, all data was non identifiable at time of data collection.  Key WordsParamedic; paramedicine; objective structured clinical examinations; OSCE; education; assessment.

Opioid crisis in primary care? An audit of high-dose opioid prescribing at Bangholm GP Practice

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711581
Author(s):  
Charlotte Greene ◽  
Alice Pearson
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Practice Guidelines ◽  
Best Practice ◽  
Evidence Base ◽  
High Dose ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Best Practice Guidelines

BackgroundOpioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018.AimAn audit at Bangholm GP Practice to understand the scale of high-strength opioid prescribing. The aim of the audit was to find out if indications, length of prescription, discussion, and documentation at initial consultation and review process were consistent with best-practice guidelines.MethodA search on Scottish Therapeutics Utility for patients prescribed an average daily dose of opioid equivalent ≥50 mg morphine between 1 July 2019 and 1 October 2019, excluding methadone, cancer pain, or palliative prescriptions. The Faculty of Pain Medicine’s best-practice guidelines were used.ResultsDemographics: 60 patients (37 females), average age 62, 28% registered with repeat opioid prescription, 38% comorbid depression. Length of prescription: average 6 years, 57% >5 years, 22% >10 years. Opioid: 52% tramadol, 23% on two opioids. Indications: back pain (42%), osteoarthritis (12%), fibromyalgia (10%). Initial consultation: 7% agreed outcomes, 35% follow-up documented. Review: 56% 4-week, 70% past year.ConclusionOpioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.

Sign in / Sign up

Export Citation Format

Share Document