Wessex Acute Frailty Audit: applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach

BMJ Open Quality

article

Lucy Anne Lewis¹  Teresa Corbett²  Kerry Burrows³  Claire Spice³  Cheryl Davies⁴  Kathy Wallis⁴ 

[1] Consultant Practitioner Development Programme , Health Education England Wessex , Winchester;Department of Health Sciences , University of Southampton;Medcine for Older People , Portsmouth Hospitals NHS Trust;Healthy Ageing Programme , Wessex Academic Health Science Network

关键词: healthcare quality improvement;    patient-centred care;    PDSA;    quality improvement methodologies;    clinical audit;   

DOI  :  10.1136/bmjoq-2019-000870

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Introduction An acute hospital stay increases the risk of negative outcomes for those living with frailty. This paper describes the application of quality improvement methodology to design and implement a regional audit to gain an understanding of care provision.Methods Small scale tests of change (Plan–Do–Study–Act cycles) were used to design the audit structure and questions. Data collectors met face to face with 2–3 multiprofessional clinicians on 58 wards in 10 hospitals across the region, using an electronic tool to gather data. Outcomes were analysed manually in Excel by extracting from the electronic audit tool.Results 58 wards across 10 hospitals participated in the audit, which identified three key themes: lack of awareness and frailty training outside medicine for older people specialties, and significant variability of both frailty identification and comprehensive geriatric assessment.Conclusion Combining quality improvement methodology with a collaborative, regional approach to design and implementation of a frailty audit creates a reliable tool ensuring all stakeholders are considering improvement from the outset. The results have facilitated an agreed regional approach on how best to use local resources to improve and standardise frailty care provision. By highlighting areas of good practice and significant gaps in frailty identification, personalised care planning and hospital wide provision of frailty training, this region of the UK will now be able to drive up standards of care.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND