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A significant case audit of a community-based elderly resource team - An opportunity for multidisciplinary teams to introduce clinical governance?

Lookup NU author(s): Professor Dame Louise Robinson, Dr Christopher Drinkwater CBE

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Abstract

Background - Analysis of critical or significant cases has been suggested as a method of multidisciplinary audit in primary care. A community-based, multidisciplinary resource team (the elderly resource team) has been established in Newcastle upon Tyne to provide integrated assessment and care for the frail elderly. Objectives - To review the clinical and administrative functioning of the elderly resource team (ERT), through a qualitative audit around significant cases, and to investigate the feasibility and acceptability of significant cases as a method of multiprofessional audit and its effectiveness in producing change in practice. Methods - Facilitated case discussion of significant cases with members of the ERT, four referring primary health care teams and an external facilitator. Following three facilitated review sessions, an audit plan was generated by the ERT. The ERT was visited six months later to assess their adherence to the plan and any subsequent change in practice. One-to-one semi-structured interviews were held with a purposive sample of participants who had attended two or more case discussions. Participants were asked their opinion about the feasibility and acceptability of significant event audit. Results - Eleven cases were discussed. Forty-four participants were involved in the discussions, 18 of whom were interviewed. The elderly resource team implemented the majority of changes in their audit plan. These were largely qualitative and centred on improving team functioning and effectiveness. All interviewees were positive about the methodology, describing it as practical, motivating, effective and relevant to primary care. Its strengths lay in its focus on real cases, its encouragement of reflective practice and that it afforded immediate and practical solutions to identified concerns. Participants considered an external facilitator essential for this method. Conclusion - Facilitated review of significant cases provides multiprofessional teams with a feasible and acceptable means for clinical audit. This method could be integrated into a clinical governance framework.


Publication metadata

Author(s): Robinson L, Drinkwater C

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Governance

Year: 2000

Volume: 8

Issue: 2

Pages: 89-96

Print publication date: 01/01/2000

ISSN (print): 1467-5277

ISSN (electronic):


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