The COGPED Completed Cycle Audit
description
Transcript of The COGPED Completed Cycle Audit
The COGPED Completed Cycle Audit
Tim Swanwick
Director of Postgraduate General Practice Education
London Deanery
what are your issues?
in pairs (5 minutes)
what are my issues?
really useful assessment very clear marking schedule no one should fail I don’t want to have to advise on so many
resubmissions!
marking schedule
1. Reason for choice of audit
2. Criterion/criteria chosen
3. Standards set
4. Preparation and Planning
5. Data collection 1
6. Changes to be evaluated
7. Data collection 2
8. Conclusions
Potential for change & relevant to practice
Relevant to audit subject and justifiable e.g. current literature
Target towards a standard with a suitable timetable
Evidence of teamwork and adequate discussion where
appropriate
Results compared against standard
Actual example described
Comparison with Data collection (1)
Summary of main issues learned
exercise
in threes “I’m going to send this in, what do you think?”
reason for choice of audit
potential for change & relevant to practice
• potential for change - can do something about problems
• relevant to practice – hospital OK – e.g. emergency admissions
common errors
• over-complicated
• too ambitious
• no potential for change
• irrelevant to practice
criterion/criteria chosen
relevant to audit subject and justifiable
• relevant – is it about the chosen subject?
• justifiable – is it a suitable thing to measure?
common errors
• no understanding of a criterion
• not “inclusion criteria”
• too many criteria
• nested criteria
• criteria confused with standards
what is a criterion?
a criterion is a statement of quality a criterion is meaningful and measurable “all” and “should” rule a criterion requires a measurable aspect of care , a
quality marker and a “population”
The last recorded BP of all patients with diabetes should be130/80 or less
All telephone calls into the surgery should be answered within five rings
examples of criteria (exercise)
In threes, give an example of a criterion in each of the following categories– chronic disease– prescribing– management of acute conditions– practice administration– screening
standards set
target towards a standard + suitable timeframe evidence that might be used
• NHS or local targets
• guidelines
• expert advice
• focus group
• benchmarking
• practice data on other audits
common errors
• confused with criteria
• not justified
• 100% usually over-zealous
what is a standard?
a figure, usually a % every criterion must have one must be justified
preparation & planning
evidence of teamwork and adequate discussion where appropriate
• teamwork is an absolute !!
• reasonable description of process
common errors
• “I did it my way…”
data collection 1
result compared with standard
• a grid makes life easier common errors
• “simply, too many notes”
• data not related to criteria
• data not compared to standard
• discrepancies unexplained
changes to be evaluated
actual examples described
• short term and..
• … long term: “what will happen in the practice when I’m gone?”
• group work
• systems, practice procedures etc
common errors
• no changes described at all
• no sustainable changes: “I wrote a letter to all the patients…”
data collection 2
comparison with data collection 1
• again a clear grid is a big help
• results may be better, worse or the same
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Standard 1st Data 2nd Data
Audit results
data collection 2 (continued)
common errors data 2 not collected in same
way as data 1 only the patients subjected to
short term intervention counted
results not compared comparison not adequately
discussed
conclusions
summary of main issues learned
• specific points about the audit
• general points about the process
common errors
• rare to fail just this
• inadequate discussion
• unjustified assertions
results
During the the period 1.4.02-31.3.03 214 GPRs passed SA in London 12 through NPMS (5.6%) 202 through audit 22 of these were resubmissions (c.10%) 2 failed during this period (c.1%)
referral
there’s no failure, only feedback
the vast majority can be rewritten
“how to do it” guide on deanery web site www.londondeanery.ac.uk
guidance on resubmission (only) from TS if required
exercise
“my audit’s been referred – help!”
questions and answers?
National Project Marking Schedule
National Project Marking Schedule (NPMS)
Approved by the JCPTGP from April 2000 A project:
– addresses a defined problem– is related to previous work– presents qualitative or quantitative findings– interprets these findings– draws conclusions from the evidence presented
NPMS
competencies tested:
– the ability to construct a logical argument– the ability to communicate in written English– the ability to plan and sustain activity over time
NPMS
range of acceptable work includes:– a small research study e.g.questionnaire, notes
review, interview study– a literature review– a case study– a proposal for a new service– a discussion paper
NPMS marking schedule
six criteria for the project each criterion marked from 0 – 5 a pass will score 18 or more each criterion must score 2 or more
NPMS marking schedule (continued)
aims/question/problem clearly stated relevant literature cited method appropriate relevant findings presented discussion appropriate conclusions appropriate
NPMS 2002/3
7% of all registrars April 2002- March 2003
– 126 audits– 87% first and second level passes– 13% referred
all marked by the Yorkshire Deanery
NPMS - The Future
National Project Marking Schedule to become “National”
Audit may become subsumed into trainer’s report
Marking panels in all deaneries Timescale … 2-3 years ?A role within the MRCGP