Critical Care - Audit and Quality Improvement

Intensive Care Unit (ICU)
Purple Zone
Level 3

General High Dependency Unit (HDU)
Green Zone
Level 3

Audit and Quality Improvement

Clinical audit plays a vital role in clinical governance and also forms the stepping stones for quality improvement projects, at the heart of which is patient care.

The aim of the Audit Team within critical care is to ensure high standards of clinical care are upheld. This includes communicating and disseminating information between members of the Multidisciplinary Team, patients their families and the wider public, to give an open and accurate account of care, planning and delivery throughout critical care.

Through audits we are able to look at trends and critically appraise current practice and identify areas for improvement. The Audit Team liaise with the critical care clinicians to determine clear objectives for the audit programme, supervise the collection of data and check the accuracy and consistency of the data collected. The Audit Team regularly evaluates, re-evaluates and monitors clinical practice by using credible systems to ensure the best possible patient care. Quality improvement is also a main focus within the audit and Multi-disciplinary Teams to raise standards and promote continuous improvement.

Here at Medway, the Critical Care Team participates in a national clinical audit called the Case Mix Programme which looks at the outcomes of patients admitted to critical care. This audit is managed by the Intensive Care National Audit and Research Centre (ICNARC), however patient data is collected locally by our critical care audit nurses. We collect data on all patients admitted to our intensive care and general high dependency unit and securely submit this data to the ICNARC Team for validation and analysis. A quarterly report is received by the unit showing how our unit compares to similar critical care units that are also involved in the programme. These reports focus on a key set of quality indicators and identify trends over time which helps us to understand more about the care that we deliver. This data helps us with decision making, resource allocation and local quality improvement initiatives. Our unit aspires to excellence and clinical audits help us to learn from the top performing units while transferring and adapting information from audited data to our own unique conditions.

The Case Mix Programme also provides the backbone for several important research studies and is a useful resource for many types of data analysis.

The annual Case Mix Programme report is available publicly via the ICNARC website.

Within our critical care units we also use local audit tools for developing local standards, policies and procedures. Audits have a huge impact within critical care in minimising risks and improving quality, safety and the sustainability of patient care and outcomes.