Published June 27, 2023
Clinical Audits and Quality Improvement Projects (QIPs) play a crucial role in healthcare in the UK. The concept may be new to you as an IMG but it’s an important one to grasp! Engaging in audits and QIPs as an IMG not only contributes to the improvement of healthcare practices, but also offers plenty of benefits for your professional development and career progression (eg. getting into specialty training!)
In this guide, we will explore the world of audits and QIPs from an IMG perspective, focusing on their relevance and significance within the NHS.
Audits involve comparing real-world healthcare practices to the recognised standards.
For example, in the NHS, the standard of care in terms of waiting times to be seen for suspected cancer is 2 weeks. A clinic can check whether or not their suspected cancer referrals are actually being seen within 2 weeks.
By making these comparisons, we can identify areas of excellence and areas that require improvement. Through this systematic evaluation, we can continuously strive for excellence in healthcare.
Quality Improvement Projects (QIP)
QIPs, on the other hand, are broader initiatives that go beyond audits. They aim to improve the overall patient experience, streamline processes, and address various aspects of healthcare that don’t always have a recognised standard.
Because QI don’t focus on on specific standards, they encourage creativity and innovation so that we can bring positive changes in areas that may not have clear guidelines.
For example, if patients often complain that they’re waiting for 3 hours to be seen for a scheduled appointment, one could start a QI project to find out what’s causing the delays and test different ways to reduce the waiting time.
Understanding the difference between audits and QIPs will help you select the best method to make a meaningful contribution to improving healthcare in your department.
But also remember that while there are distinct differences between clinical audits and quality improvement projects, they share the common goal of improving healthcare quality. Both approaches play important roles in driving positive change and enhancing patient outcomes.
|Clinical Audits||Quality Improvement Projects (QIPs)|
|Evaluates if healthcare meets standards||Aims to improve patient experience and streamline processes|
|Focuses on current practices||Explores areas for improvement beyond established benchmarks|
|Follows a structured cycle||Iterative process using the Plan-Do-Study-Act (PDSA) framework|
|Relies on established guidelines||May involve developing new standards or addressing areas without specific guidelines|
|Collects data to measure compliance||Collects data to identify areas for improvement and measure impact|
|Compares data against set standards||Analyses data to assess effectiveness of changes implemented|
|Focuses on meeting standards and compliance||Focuses on implementing improvements and optimising processes|
|Conducts reaudits to assess impact||Conducts ongoing assessments and reaudits to monitor progress|
|Provides insight and identifies gaps||Improves patient experience and fosters continuous improvement|
|Enhances quality of care||Drives continuous improvement in patient experience and outcomes|
Benefits and Importance for IMGs
These activities may appear as chores, but they offer numerous benefits for you as an IMG.
- Engaging in audit and QI demonstrates a commitment to delivering high-quality care that prioritises patients’ needs.
- Taking an active role in audit and QI, such as leading the project, often garners points in the portfolio when applying for specialty training.
- Audits and QIPs provide platforms for developing essential skills, including critical thinking, data analysis, project management, and effective communication with diverse healthcare teams.
- IMGs interested in management can acquire transferable skills through audit and QI.
- Audits and QIPs facilitate interactions with members of the wider healthcare team, solidifying an IMGs’ position within the department.
How to conduct a Clinical Audit or Quality Improvement Project (QIP)
Step 1: Choose a Topic
Select a topic based on departmental concerns or interests. Review outcomes or patient feedback for ideas on areas that need improvement. Collaborate with consultants or senior registrars for guidance and alignment with departmental goals.
Step 2: Define the Objectives
Define clear objectives and set criteria or standards for evaluation. For audits, use national guidelines, local protocols, or professional recommendations as a reference. For QI projects, collaborate with other members of the healthcare team to come up with achievable targets.
Step 3: Data Collection
Utilise electronic medical records, patient notes, or relevant departmental data for information gathering. Seek support from the audit or medical records department for efficient and accurate data collection – if there is one!
Step 4: Analysis & Interpretation
Use statistical tools and visual representations like graphs or charts to compare data against the defined standards. Identify areas of excellence and areas requiring improvement.
Step 5: Present the Results
Share findings with stakeholders through departmental meetings, morbidity and mortality meetings, or conference submissions. Encourage feedback, discussion, and collaboration for implementing changes.
Step 6: Implement Changes
Collaborate with department heads, colleagues, and multidisciplinary teams to develop action plans addressing areas for improvement. Monitor progress and re-audit to evaluate effectiveness. Re-auditing is sometimes referred to as “closing the cycle” or “closed-cycle audits”. Doing this second cycle of the audit always gains more points in the portfolio.
Tips and Strategies for Success
Embarking on audits and QIPs as an IMG in the NHS can be a rewarding and impactful endeavour. To ensure successful outcomes, here are some of our tips and strategies:
- Choose the right project: You’re going to be spending quite some time on this so you need to be motivated throughout. Select an audit or QIP topic that aligns with your interests, departmental goals, and has the potential for meaningful impact on patient care.
- Collaborate and seek support: Audits and QIPs are not meant to be done solo. Engage with consultants, senior registrars, and multidisciplinary teams to gain insights, guidance, and support throughout the process. Collaboration fosters a more comprehensive and effective approach.
- Plan effectively: You’ll be doing this on top of your regular job, so it’s important to develop a clear timeline, set achievable goals, and allocate resources accordingly. A well-structured plan ensures a smooth and organised execution of the project.
- Data collection and analysis: Data collection often falls to doctors and it’s a tedious process, that’s why we recommend using electronic records wherever possible.
- Implement changes with purpose: If a change depends on you as an individual, then it won’t carry on when you leave that department which would be a shame for patients. Make sure engage key stakeholders, including department heads, colleagues, and patients, to implement identified improvements effectively.
- Monitor progress and re-audit: Continuously evaluate the impact of implemented changes and monitor progress against the project objectives.
- Share and learn from results: Sharing your experiences and lessons learned contributes to the broader knowledge and inspires others. Present your findings in departmental meetings, conferences, or through publications.
By following these tips and strategies, you can effectively navigate audits and QIPs, and contribute to healthcare improvement, while demonstrating your commitment to enhancing patient care in the NHS.
- Clinical Audits and Quality Improvement Projects (QIPs) are important in healthcare in the UK and offer several benefits for IMGs both personally and professionally.
- Audits compare healthcare practices to recognised standards, while QIPs aim to improve the overall patient experience and allow us address areas that don’t always have clear guidelines.
- Audits follow a structured cycle, while QIPs use the iterative Plan-Do-Study-Act (PDSA) framework.
- Audits focus on meeting standards and compliance, while QIPs focus on implementing improvements and optimising processes.
- Both audits and QIPs involve data collection and analysis, with audits measuring compliance and QIPs identifying areas for improvement.
- Audits conduct re-audits to assess impact, while QIPs involve ongoing assessments and reaudits to monitor progress.
- Engaging in audits and QIPs demonstrates commitment to high-quality care and can benefit IMGs in terms of career progression and skills development.
- Steps for conducting audits and QIPs include choosing a topic, defining objectives, data collection, analysis and interpretation, presenting results, and implementing changes.
- Tips for success include choosing the right project, collaborating and seeking support, planning effectively, using electronic records for data collection, implementing changes with purpose, monitoring progress, and sharing and learning from results.
Additional Resources and Further Reading
- NHS Impact: The official website of NHS Impact provides resources, templates, and guidance on conducting audits and quality improvement projects. Visit their website for valuable insights and practical tools.
- Healthcare Quality Improvement Partnership (HQIP): HQIP offers a range of resources and publications focused on quality improvement in healthcare. Their website provides access to national clinical audits, reports, and improvement tools.
- Royal Colleges and Specialty Societies: Consult the websites of relevant royal colleges and specialty societies for specific guidelines, recommendations, and resources related to audits and quality improvement in your chosen specialty.
- ResearchGate: Explore the ResearchGate platform to access research papers, case studies, and scholarly articles related to audits, quality improvement, and patient safety.
- Professional Networks and Conferences: Engage with professional networks, attend conferences, and participate in workshops related to audits and quality improvement. These opportunities provide valuable networking, learning, and sharing platforms.
Bear in mind that continuous learning and collaboration are essential for the success of audits and QIPs. Stay actively involved, seek mentorship, and consistently explore new resources and opportunities to enhance your skills and contribute to the improvement of patient care in the NHS.