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Undertaking clinical audit, with reference to a Prescribing Observatory for Mental Health audit of lithium monitoring

  • Carol Paton (a1) (a2) and Thomas R. E. Barnes (a1) (a3)
Summary

Audit is an important tool for quality improvement. The collection of data on clinical performance against evidence-based and clinically relevant standards, which are considered by clinicians to be realistic in routine practice, can usefully prompt reflective practice and the implementation of change. Evidence of participation in clinical audit is required to achieve intended learning outcomes for trainees in psychiatry and revalidation for those who are members of the Royal College of Psychiatrists. This article addresses some of the practical steps involved in conducting an audit project, and, to illustrate key points, draws on lessons learnt from a national, audit-based, quality improvement programme of lithium prescribing and monitoring conducted through the Prescribing Observatory for Mental Health.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Declaration of interest

None.

Footnotes
References
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1 Chief Medical Officer. Good Doctors, Safer Patients. Department of Health, 2006.
2 Royal College of Psychiatrists. Revalidation Guidance for Psychiatrists (College Report CR172). Royal College of Psychiatrists, 2012.
3 Royal College of Psychiatrists. A Competency Based Curriculum for Specialist Training in Psychiatry: Specialist Module in General Psychiatry. Royal College of Psychiatrists, 2009 (http://www.rcpsych.ac.uk/pdf/General_Feb09.pdf).
4 National Institute for Clinical Excellence. Principles for Best Practice in Clinical Audit. Radcliffe Medical Press, 2002. (http://www.nice.org.uk/media/796/23/BestPracticeClinicalAudit.pdf).
5 Collins, N, Barnes, TRE, Shingleton-Smith, A, Gerrett, D, Paton, C. Standards of lithium monitoring in mental health Trusts in the UK. BMC Psychiatry 2010; 10: 80.
6 Palmer, L. Ensuring that High Ethical Standards are Applied to Clinical Audit. Royal College of Psychiatrists, no date (http://www.rcpsych.ac.uk/workinpsychiatry/qualityimprovement/ccqiethicalaudit.aspx).
7 NHS Commissioning Board. Commissioning for Quality and Innovation (CQUIN): 2013/14 Guidance. NHS Commissioning Board, 2013.
8 Care Quality Commission. The Essential Standards. Care Quality Commission, no date (http://www.cqc.org.uk/organisations-we-regulate/registering-first-time/essential-standards).
9 NHS Litigation Authority. NHSLA Risk Management Standards 2012–13. NHS Litigation Authority, 2012.
10 Department of Health. Code of Practice: Mental Health Act 1983. TSO (The Stationery Office), 2008.
11 National Institute for Health and Clinical Excellence. Bipolar Disorder. The Management of Bipolar Disorder in Adults, Children And Adolescents, in Primary and Secondary Care. Clinical Guideline 38. National Institute for Heath and Care Excellence, 2006.
12 National Patient Safety Agency. Safer Lithium Therapy (Patient Safety Alert). National Patient Safety Agency, 2009 (http://www.nrls.npsa.nhs.uk/alerts/?entryid45=65426).
13 Royal College of Psychiatrists. What is POMH-UK? Royal College of Psychiatrists, no date (http://www.rcpsych.ac.uk/workinpsychiatry/qualityimprovement/nationalclinicalaudits/prescribingpomh/prescribingobservatorypomh.aspx).
14 Raleigh, VS, Foot, C. Getting the Measure of Quality: Opportunities and Challenges. The King's Fund, 2010.
15 Barnes, TRE, Paton, C. Improving prescribing practice in psychiatry. Int Rev Psychiatry 2011; 23: 328–35.
16 Barnes, TRE, Paton, C. Role of the Prescribing Observatory for Mental Health. Br J Psychiatry 2012; 201: 428–9.
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BJPsych Bulletin
  • ISSN: 2053-4868
  • EISSN: 2053-4876
  • URL: /core/journals/bjpsych-bulletin
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Undertaking clinical audit, with reference to a Prescribing Observatory for Mental Health audit of lithium monitoring

  • Carol Paton (a1) (a2) and Thomas R. E. Barnes (a1) (a3)
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