Clinical Audit in pre-hospital emergency care provision
Pre-hospital emergency care entails clinical practice in the form of interventions delivered and/or medications administered to the patients encountered. The standards are set through the Clinical Practice Guidelines published by PHECC.
To ensure that patients are receiving appropriate clinical care it is imperative that Licenced CPG Providers demonstrate, through valid measurement tools, that the required standards are being met. One valid measurement tool is clinical audit.
“Effective clinical governance is not the responsibility of any one person – rather it is collective, with all staff at every level having a shared responsibility and accountability for ensuring that service users receive the right care, at the right time from the right person. It is the professional and ethical responsibility of all staff who are involved in the provision of clinical care, irrespective of grade or rank, to proactively contribute to the progression of the clinical governance agenda across their service” (HIQA 2014).
PHECC has a requirement that Licensed CPG Providers conduct at least three clinical audits per annum. The experience to date has been a lack of awareness of what clinical audit entails and the submitted clinical audits from Licensed CPG Providers has not been satisfactory. In an attempt to address this situation PHECC ran a clinical audit workshop in June 2014 where all the Licensed CPG Providers were invited to attend. This workshop was facilitated by Dr Ian Callanan who is the Group clinical audit facilitator for the St Vincent’s Healthcare Group and the National Lead for clinical audit in 2011.
One of the requirements of the renewal of approval for Licensed CPG Providers is to submit three clinical audits conducted within the previous year. All of the renewal applications to date had issues with clinical audit despite attendance at the clinical audit workshop. In an effort to support the Licensed CPG Providers PHECC has recommended ‘A Practical Guide to Clinical Audit’ 2013 published by HSE to these organisations. PHECC has further adapted this clinical audit standard, with approval from the HSE, and has made it a PHECC standard. This was approved by Council at its December 2014 meeting.
This new standard is available at here
Clinical audit is a cyclical process where an element of clinical practice is measured against a standard, the results analysed, an improvement plan implemented and the clinical practice measured again to identify improvements, if any.
Health Information and Quality Authority, 2014, Review of pre-hospital emergency care services to ensure high quality in the assessment, diagnosis, clinical management and transporting of acutely ill patients to appropriate healthcare facilities