UL Hospitals Group Hosts Inaugural Clinical Audit and Quality Improvement Conference

In Ireland, quality is based upon the four domains set out in the National Standards for Safer Better Healthcare (HIQA, 2012)

• Person centred: care that is respectful and responsive to individuals needs and values and partners with them in designing and delivering that care.
• Effective: care that is delivered according to the best evidence as to what is clinically effective in improving an individual’s health outcomes.
• Safe: care that avoids, prevents and minimises harm to patients and learns from when things go wrong.
• Better health and wellbeing: care that seeks to identify and take opportunities to support patients in improving their own health and wellbeing.

Quality improvement means using the right tools and methods to introduce and embed changes for the better in healthcare delivery. It involves all healthcare professionals, health managers, academics and, crucially, service users, in the effort to bring about these changes in a systematic way and to measure their input. Through these combined and continuous efforts, we can introduce changes resulting in better patient outcomes; better experience of care; continued development and supporting of staff in delivering quality care.

Over 200 delegates attended the conference at the Clinical Education and Research Centre, University Hospital Limerick. Many of the speakers and poster presentations concern specific quality improvement projects undertaken at UL Hospitals Group and elsewhere. And another key focus of the daylong event is clinical audit.

Clinical audits involve a systematic approach to comparing existing clinical practice to defined standards. Any gaps in practice identified by the clinical audits will lead to quality improvement projects aimed at eliminating such gaps and achieving the desired standard of care. Clinical audits performed following a quality improvement project can lead to quality assurance.

Quality improvement projects can also originate as a result of new developments and new risks. UL Hospitals Group has formed a Quality Improvement Committee to spread a culture of quality through its six hospitals. This committee is focused on driving the enthusiasm for participation in quality improvement projects. The leadership of UL Hospitals Group is committed to supporting these projects so that quality improvement becomes our behaviour.

Speaking at the conference, Dr Naro Imcha, Chairperson of the Quality Improvement Committee, UL Hospitals Group, explained the emerging paradigm.

“For many decades, quality was considered as a cost and therefore quality improvement used to be a reactive undertaking. The quality perspective has completely shifted away from cost to the human who is at the centre of care. Now, quality is the essential feature of care provided and this demands that quality undergoes constant improvement,” said Dr Imcha.

“Healthcare organisations are extremely complex and quality improvement efforts can only be sustainable with the wholehearted participation of everyone at all levels of the organisation. Nobody is too small or too big to work for quality improvement. It is an indispensable element of every job description,” she added.

Commenting on the clinical audit function and process, Dr John Kennedy, Associate Clinical Director, Quality and Patient Safety, UL Hospitals Group said:

“Clinical audit in the Group has developed in the last number of years. This has been aided by the audits set up and supported by the National Audit Office and national clinical programmes. These nationally supported audits allow the results in a number of areas to be benchmarked against national and, in some cases, international comparisons. The results to date are overall reassuring. Oversight of a number of these key audits is provided to the Group Executive by the Clinical Audit Committee.

“The challenge for the future is to continue to strengthen internal audit procedures, particularly at directorate and department level. In addition, and most importantly, we must

strengthen audit reports as drivers for quality initiatives to maintain the quality improvement cycle,” Dr Kennedy said.

Among the speakers at the conference were:

• Mr Manoj Kumar, National Clinical Lead Scottish Morbidity and Mortality, Consultant General Surgeon, NHS Grampian; Human Factors/Ergonomics and Quality Improvement: Scotland’s Approach to Frontline Safety Reviews.
• Prof Gerry Fitzpatrick, Vice-president Elect, College of Anaesthetists of Ireland; Safety and Quality of Anaesthesia in Ireland.
• Dr Jane Carthey, Human Factors & Patient Safety Consultant, Putting Human Factors at the Heart of Quality Improvement.
• Prof Colette Cowan, CEO, UL Hospitals Group, and Ms Marti Lotter, Head of Governance, UL Hospitals Group; Transformation of Healthcare Services Through Effective Governance.

Among the local QI projects showcased was the Bed Bureau, which has reduced unnecessary Emergency Department waits for patients in UL Hospitals Group by providing a single point of access to GPs referring patients with medical conditions. The benefits of the Bed Bureau project - for patients, GPs, staff and UL Hospitals - were shared by Ennis-based GP Dr Bruce O’Donnell and Ms Noreen Spillane, Chief Operations Officer, UL Hospitals Group.

The conference was opened by Prof Colette Cowan, CEO, UL Hospitals Group and attended by Mr John Connaghan, Interim Director General of the HSE.

Dr Philip Crowley, National Director for Quality Improvement, HSE, also spoke on Putting Quality at the Centre of UHL.

“This an important day for UL Hospitals Group, where their great work in improving the quality of their care and their commitment to auditing care to ensure standards are met, get a welcome showcase. The staff working in the group deserve great credit for the work they are presenting today,” Dr Crowley said.