A Cross-Sectional Study of Experiences and Attitudes towards Clinical Audit of Farm Animal Veterinary Surgeons in the United Kingdom

Surgical safety checklists in UK veterinary practice: Current implementation and attitudes towards their use

BACKGROUND

Surgical safety checklist (SSC) use benefits veterinary patients, but endorsement and implementation are essential for these benefits to be observed.

METHODS

A cross-sectional survey assessed UK veterinary professionals' attitudes towards and usage of SSCs and identified factors associated with poorer attitude or failure to use SSCs.

RESULTS

Of 513 respondents, 70% used SSCs. Of these, 87.1% used SSCs for every surgical procedure, 19.1% adapted SSCs for different procedures and 61.1% had a standard operating procedure detailing how to use SSCs. Attitudes towards SSC use were favourable, with increased positive attitude associated with employing at least one registered veterinary nurse with a post-qualifying qualification (p < 0.001), current SSC use (p < 0.001), undertaking self-directed reading (p = 0.033) or completing SSC-relevant post-qualification continuing professional development (p = 0.005). Factors associated with veterinary practices not using SSCs included Practice Standards Scheme (PSS) non-membership (odds ratio [OR] 2.0, 1.1-3.4), no RCVS hospital status (OR 1.9, 1.1-3.5) or being a mixed first-opinion veterinary practice (OR 2.4, 1.2-5.0).

LIMITATIONS

Study limitations include sampling methodology and non-validated attitudinal scale usage.

CONCLUSION

Most respondents used SSCs. Familiarity, education and the RCVS PSS were associated with improved uptake and attitudes, but mixed practice was associated with reduced usage.

Physicians' knowledge, attitude and practice of clinical audit in a tertiary health facility in a developing country: a cross-sectional study

INTRODUCTION

health outcomes in hospitals can be improved through regular conduct of clinical audit. This study assessed physicians´ knowledge, attitude, and practice of clinical audit at the University of Port Harcourt Teaching Hospital (UPTH) in Rivers State.

METHODS

a descriptive cross-sectional study involving 460 doctors selected through convenience sampling. A pretested self-administered questionnaire was administered, and data was analysed using the Statistical Package for Social Research (SPSS) 23.0.

RESULTS

a total of 457 questionnaires were analyzed giving a response rate of 99.3%. Only 57 (12.5%) of the 457 respondents had a correct understanding of the clinical audit process. Most respondents (75.1%) agreed that clinical audit is important in improving patient care, however only 29.9% were aware that the hospital has a clinical governance structure. Seventy-three (16.0%) doctors had received training in different forms of clinical audit, while 148 (33.0%) were involved in different clinical audit activities, with mortality audit being the most common clinical audit type (81, 17.7%).

CONCLUSION

physicians at the University of Port Harcourt Teaching Hospital have poor understanding of the clinical audit process. The integration and scale-up of clinical audit activities as part of an overall clinical governance system in the teaching hospital is recommended.

Developing consensus for definitions of key veterinary-specific quality improvement (QI) terms using an eDelphi-study method

BACKGROUND

Quality improvement (QI) methods are a continuous process of iterative tests to improve the quality of a service or product. Using common language has been linked to the successful implementation of QI in human healthcare. This study aimed to assimilate and achieve consensus on veterinary-specific definitions for terms associated with quality care and QI methods in UK veterinary practice.

METHODS

A four-round modified eDelphi process with a panel of 50 UK veterinary practice stakeholders was used to generate consensus. The panel selected or suggested the definition they best felt 'fitted' each term. Consensus was reached if there was >70% agreement, and terms were eliminated if there was <15% selection.

RESULTS

Thirty-one panellists completed all three rounds of eDelphi; eight participants completed an optional feedback round. From 14 terms, 10 reached consensus, leaving four unresolved definitions.

CONCLUSIONS

A majority of terms reached consensus; 90% were new or amended definitions proposed by panel members. Utilising plain English refined by stakeholders will allow successful implementation of QI in veterinary healthcare. Not all terms achieved consensus, highlighting a need for further research to enable successful integration of QI principles as seen in human healthcare.

Assessing the Feasibility of Retrospective and Prospective Clinical Audit in Farm Animal Veterinary Practice

As a quality improvement tool, clinical audit has been extensively described in the medical literature. There is scant literature on the use of clinical audit in the farm animal veterinary setting. This study describes the process and feasibility of prospective and retrospective data collection for farm animal clinical audit performed at three different farm animal practices in the United Kingdom. Retrospective clinical audit was difficult in all three practices due to barriers in establishing diagnosis and patient identity from clinical records. Prospective data collection proved feasible but depended on adequate case accrual and practitioner engagement. The decision to conduct clinical audit retrospectively or prospectively will depend on the topic to audit, the availability of data and the wishes of the team members involved. Further work is required looking at the use of clinical coding and alternatives to using practice management software to improve retrospective data availability for clinical audit.