10


• Dental Audit


NOT JUST AN


ACADEMIC EXERCISE


Claire Renton suggests how dental audit can be more than just a box-ticking exercise


L


OVE it or hate it, audit is here to stay. Since 2001 dentists in Scotland with an NHS list have been required to carry out audit as part of their terms of service. Many of us have asked what is the


purpose of audit? Is it really worth doing? Or is it something we do reluctantly because we are obliged to? The Royal College of Surgeons of England tells


us that: “The aim of clinical audit is to improve patient treatment by improving professional practice and the quality of services delivered.” This is indeed a grand aspiration. To carry out a project that improves patient treatment, professional practice and services to patients really could not be faulted. But what if the audit project also or (dare I say


it) instead was designed primarily to make our busy lives easier: a project that made cash flow better within the practice, a project that ensured patients turned up for their appointments when they were supposed to, or one that organised staffing better within the practice. Well, why not? All of the above would ultimately do all the things the Royal College says are the main aims of an audit project and it seems sensible to me that if you are going to carry out an audit project then one of the best places to start is with something that annoys you about clinical practice.


Topics relevant to you There are a few critical steps to audit. The first rather obviously is to select what you want to audit. Pick something that you would like to improve about your working day. No, a


longer lie-in and extended lunch break don’t count! But what about those “failed to attend” appointments that drive you mad? We’ve all been there, set up for that crown


prep, impression trays ready, retraction cord found, X-rays checked and... maybe she’s held up in traffic or maybe she just can’t get parked. But no, she’s either forgotten or found something better to do but she’s not turned up. What a hassle it is then, packing up all the kit, contacting the patient to rearrange another appointment not to mention that if you are an associate in this position you’ve not earned anything for the last hour. If you own the practice, then not only have you not earned anything but you’ve had the staff to pay as well as all the other overheads too. Other concerns in this situation might include the impact this has on other patients who might have been seen had the patient phoned to cancel the appointment a few days before. So perhaps a project about patients failing to attend might just be the answer. What about other topics? Sometimes


significant event analyses (SEAs) in your practice can provide good topics for audit. NHS Education for Scotland (NES) suggests also selecting an audit topic with:


• Clear national standards and guidelines available, e.g. SDCEP guidance on problems encountered in practice


• Clear potential for improving patient care • Areas of high volume, high risk or high cost,


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