Clinical audit
Turning healthcare data into a single source of truth
Nick Westall, Chief Technology Officer of Athera Healthcare, explores the many ways data is being processed across the NHS to convert it into actionable insights that help deliver better patient care, outcomes and safety.
The NHS now holds one of the richest healthcare datasets in the world and it’s growing minute- by-minute, as the drive for a digital-first NHS continues. The challenge isn’t the collection of data - that’s abundant. The real challenge is how to turn these data-based ‘breadcrumbs’ into actionable insights - to create a single source of truth, where vital health learnings are gained, and areas for improvement can be identified. One of the many ways that’s being achieved is through clinical audits.
From audit to action Used across the NHS – and beyond – clinical audits help ensure healthcare is being delivered to the highest possible standards. Commissioned locally and nationally, these audits help paint the most accurate picture of what’s happening within healthcare. They systematically assess where services are being delivered well and where challenges are being experienced. A great example of the impact clinical audits
can make, especially in striving to achieve a single source of truth, was recently found within maternity care.
Helping to uncover the unknowns in maternity care In England, it’s estimated that every minute a baby is born. But sadly, around 200 new mothers and 5,000 babies also die each year. According to the NHS Transformation Directorate, sadly too many of these deaths are avoidable, and around 13% of all patient negligence claims are also linked to obstetrics.1 Data insights are therefore vital in allowing
the NHS to gain a deeper understanding into preventable maternal and infant deaths and that’s where the power of clinical audits comes in. A poignant example of this can be seen in our work with the Maternal Enhance and Critical Care (MEaCC) Steering Group for Bradford Teaching Hospital NHS Foundation Trust. The Yorkshire and Humberside region is
responsible for around 10 per cent of births in England. The region’s data holds immense
potential for understanding the circumstances surrounding maternal deterioration during childbirth, as well as helping to identify patients’ and babies’ specific care needs. It was found that of the women who require crucial or enhanced maternal care during childbirth – 9 out of 10 arrive at the delivery suite fit and healthy. “There is a big focus nationally in maternal
care on looking after really sick women,” said Dr. Deborah Horner, Consultant in Anaesthetics and the Chair of the region’s MEaCC Steering Group. She added, “It turns out that if you only look out for women with complex health problems, you are potentially missing 90% of women who are likely to become ill. No one knew that.”
Digging deeper into the data That alone is a powerful piece of insight and it’s gone on to help create a new standard of care for both identifying, and also looking after unwell women outside of critical care, which is being tested using the Athera Insights clinical audit system. But that’s not all… Across each maternity unit, midwives are now using the system to capture clinical data. With insights serving up some of the most common problems women encounter when needing
maternal enhanced or critical care - such as postpartum haemorrhage, hypertension, and sepsis. It has also helped highlight the wider, multidisciplinary support patients may benefit from – such as women who may need psychological support following trauma caused through childbirth. What is more, the audit has gone on to highlight clinical resourcing needs - an area which previously had little data to support accurate and informed decision making. The work with MEaCC has the potential to positively benefit the lives of patients across the region, but it’s insight that can also go on to influence the national health agenda on maternal care.
Increasing understanding Early diagnosis of inflammatory arthritis is vital to long-term patient outcomes, and in some cases, treatment remission can be possible. Continuous understanding of the illness is therefore key. To achieve this, the British Society of Rheumatology (BRS) launched the National Early Inflammatory Arthritis Audit and it turned into one of the largest clinical audits of its kind. In just 9 months more than 12,000 patients
shared their experiences of living with arthritis at various intervals during their care treatment
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