Using Lazomis QI for Effective Clinical Audit in the NHS

Why Clinical Audit Matters and Where Lazomis QI Fits In

Clinical audit provides a robust mechanism for measuring the quality of care provided against agreed standards. It forms a critical part of clinical governance, demonstrating accountability and driving patient safety and effectiveness. The audit cycle – from defining standards to implementing change and re-auditing – is a continuous improvement loop.

However, common challenges include the administrative burden of data collection, difficulty in data analysis, lack of clear structure for project management, and ensuring that findings lead to tangible improvements. Lazomis QI is designed to address these challenges by providing a structured platform that supports each stage of the audit cycle, making it more accessible and impactful for clinical teams.

Understanding the Clinical Audit Cycle with Lazomis QI

The clinical audit cycle typically involves five key stages:

1. Defining Standards and Criteria: Based on national guidance (e.g., NICE, Royal College guidelines) or local protocols.
2. Data Collection: Gathering information about current practice.
3. Data Analysis and Comparison: Comparing current practice against defined standards.
4. Implementing Change: Developing and putting into practice improvements based on audit findings.
5. Re-audit: Measuring the impact of changes to ensure sustained improvement.

Lazomis QI provides dedicated features that align with and enhance each of these stages, offering a digital framework for what can often be a paper-heavy or fragmented process.

Practical Application: Using Lazomis QI for Clinical Audit

Step 1: Project Setup and Scope Definition

• Initiate a New Project: Within Lazomis QI, start a new project. Give it a clear, descriptive title, such as "Audit of VTE Prophylaxis in Elective Orthopaedic Surgery." Define the project lead (often a trainee or QI lead) and involved team members.
• Define Aims and Objectives: Clearly articulate what the audit seeks to achieve (e.g., "To determine adherence to local VTE prophylaxis guidelines for elective hip and knee replacements"). Lazomis QI's project brief section can house these details, ensuring all team members are aligned.
• Establish Standards and Criteria: Based on national guidelines (e.g., NICE NG89, local formulary). Document these within the project, including the measurable criteria and the expected compliance rate (e.g., "95% of patients undergoing elective hip replacement receive appropriate VTE prophylaxis on admission").
• Define Sample Size and Methodology: Outline the patient cohort, inclusion/exclusion criteria, and the period of data collection. Lazomis QI's project notes or attached documents can store your audit protocol.

Step 2: Designing Your Data Collection Tool

• Utilise Custom Forms: Lazomis QI allows you to build bespoke data collection forms tailored to your audit criteria. Create fields for each data point required (e.g., patient identifier, admission date, procedure, VTE risk factors, prophylaxis prescribed, date of prescription, contraindications).
• Standardise Data Entry: Use dropdown menus, checkboxes, and numerical fields where possible to minimise free-text entry and ensure data consistency. This is crucial for accurate analysis later.
• Guidance for Data Collectors: Include brief explanations or instructions within the form fields to guide those undertaking data collection, ensuring clarity on what data to extract and from where (e.g., electronic patient record, drug chart).

Step 3: Efficient Data Collection

• Team Collaboration: Assign data collection tasks to team members within the project. Lazomis QI's collaborative features allow multiple users to input data simultaneously or sequentially.
• Real-time Progress Tracking: Monitor data collection progress via the project dashboard. This allows leads to identify bottlenecks or support required for team members.
• Secure Data Handling: Lazomis QI is designed with NHS data security standards in mind. Ensure all collected data adheres to local information governance policies. Avoid collecting direct patient identifiers unless absolutely necessary and approved by local IG. Focus on anonymised or pseudonymised data where possible.

Step 4: Analysis and Interpretation

• Automated Data Visualisation: Once data is collected, Lazomis QI can automatically generate charts and graphs based on your form fields. This quickly visualises compliance rates against your predefined standards.
• Identify Deviations: Easily spot areas where practice deviates from standards. For example, a bar chart might show that only 70% of patients received appropriate VTE prophylaxis, highlighting a gap from your 95% target.
• Deep Dive with Filtering: Use filtering options to explore specific subgroups or variables. For instance, filter by consultant, ward, or procedure type to identify specific areas of good practice or areas needing targeted intervention.
• Generate Reports: Lazomis QI can help compile findings into preliminary reports, including summary statistics and visualisations. This forms the basis for your formal audit report.

Step 5: Action Planning and Implementation

• Develop Action Plans: Based on the analysis, create specific, measurable, achievable, relevant, and time-bound (SMART) action plans within the project. For example, "Develop a ward-based education session on VTE prophylaxis guidelines for junior doctors, to be delivered by October 2024."
• Assign Responsibilities and Deadlines: Assign actions to specific team members and set realistic deadlines. Lazomis QI allows you to track the progress of these actions.
• Communicate Findings: Share your audit findings and action plans with relevant stakeholders, including clinical governance committees, departmental meetings, and frontline staff.

Step 6: Re-audit for Sustained Improvement

• Plan the Re-audit: After a suitable period for the implemented changes to take effect (e.g., 6-12 months), plan a re-audit using the same methodology and data collection tools within Lazomis QI.
• Compare Results: Easily compare the re-audit data with the initial audit data within Lazomis QI to demonstrate the impact of your interventions.
• Close the Loop: Document the outcomes of the re-audit, confirming whether the desired improvements have been achieved and identifying any further areas for action. This completes the audit cycle and demonstrates effective clinical governance.

Common Pitfalls and How to Avoid Them with Lazomis QI

• Poorly Defined Standards: If standards are vague, audit results will be uninterpretable. Lazomis QI cannot invent standards, but it provides a clear place to document them, encouraging upfront clarity.
• Inconsistent Data Collection: Different collectors interpreting questions differently. Lazomis QI's structured forms with clear instructions and choice-based inputs (dropdowns, checkboxes) minimise ambiguity.
• Data Overload: Collecting too much data or data that isn't relevant. Lazomis QI encourages focused form design based on your specific audit questions, preventing unnecessary burden.
• Analysis Paralysis: Struggling to make sense of large datasets. Lazomis QI's automated visualisations provide immediate insights, allowing teams to quickly identify key findings without complex statistical software.
• Lack of Follow-Through: Audit findings not leading to action. Lazomis QI's integrated action planning and tracking features ensure accountability and help drive the implementation of changes.
• Information Governance Concerns: Not handling patient data appropriately. While Lazomis QI offers a secure platform, users must ensure their audit protocols and data points comply with local IG policies and avoid direct patient identifiers where possible, or seek explicit approval for their collection.

Example in Clinical Practice: Audit of Sepsis Screening Compliance

A team of junior doctors and a QI lead decide to audit compliance with the national sepsis screening tool in their Emergency Department (ED).

1. Setup in Lazomis QI: A new project is created, titled "ED Sepsis Screening Compliance Audit." The aim is set: "To assess adherence to the Sepsis Six pathway screening documentation for patients presenting with suspected infection in ED." Standards are noted: "100% of patients with suspected infection should have a complete Sepsis Six screening documented within 1 hour of presentation."
2. Form Design: A custom form is built with fields for: date/time of presentation, suspected infection (Y/N), time of screening initiation, completion of each Sepsis Six component (e.g., Oxygen, Blood Cultures, Lactate, IV Fluids, Antibiotics), and documented time of each component. Dropdowns for 'Yes/No' and time stamps are used.
3. Data Collection: Over two weeks, the junior doctors retrospectively review 100 patient notes of those admitted with suspected infection. They input data directly into the Lazomis QI form.
4. Analysis: The Lazomis QI dashboard immediately shows that only 65% of patients had complete screening within 1 hour. Further filtering reveals that lactate measurements are often delayed, and antibiotics are sometimes not administered within the golden hour.
5. Action Plan: An action plan is developed: 1) ED nursing and medical staff training on timely lactate sampling (assigned to ED lead nurse). 2) A prompt on the electronic prescribing system for suspected sepsis patients to expedite antibiotic prescription (assigned to digital lead). 3) A poster campaign in ED staff areas to raise awareness.
6. Re-audit: Three months later, the team performs a re-audit using the same Lazomis QI form. The dashboard now shows 85% compliance, with marked improvement in lactate sampling and antibiotic administration times. The team identifies remaining challenges and plans further interventions, demonstrating continuous improvement.

This resource supports, but does not replace, clinical judgement. Local policy, formulary and specialist advice should be followed.

How Lazomis Can Help

Lazomis QI provides a dedicated, secure platform designed to streamline clinical audit projects within the NHS context. Our intuitive tools allow teams to:

• Structure Audit Projects: From defining aims and standards to tracking actions, Lazomis QI keeps your audit organised.
• Simplify Data Collection: Create bespoke, easy-to-use digital forms that standardise data input and reduce administrative burden.
• Automate Analysis and Visualisation: Instantly generate clear graphs and charts from your collected data, providing rapid insights without complex spreadsheets.
• Facilitate Collaboration: Enable multiple team members to contribute to data collection and action planning simultaneously, improving efficiency.
• Drive Action and Re-audit: Track the implementation of changes and easily conduct follow-up audits to demonstrate sustained improvement and close the audit loop.

By centralising your audit efforts, Lazomis QI helps NHS teams move beyond manual processes, freeing up valuable clinical time and enhancing the impact of audit findings on patient care.

Key Takeaways

• Clinical audit is fundamental to NHS quality improvement and governance, ensuring care meets standards.
• Lazomis QI provides a structured digital platform to manage all stages of the clinical audit cycle efficiently.
• Custom forms in Lazomis QI standardise data collection, reducing errors and saving time.
• Automated analysis and visualisation tools offer immediate insights into compliance and areas for improvement.
• Integrated action planning and re-audit features support the full audit cycle, driving sustained improvements in patient care.