Quality Improvement/Clinical Audit

The Musculoskeletal (MSk) Audit

The Musculoskeletal (MSk) Audit began in April 2009 and will provide data to compliment the work of various hospital time-to-treatment teams by identifying rate-limiting steps for orthopaedic treatment. This will help orthopaedic departments meet their December 2011 Referral to Treatment target of patients waiting no longer than 18 weeks from receipt of a referral (e.g. from a GP) until starting treatment.

Funding for the audit has come from the Scottish Government’s Health Delivery Directorate. The audit resources have been transferred from the previous successful Scottish Hip Fracture Audit (SHFA) which completed data collection at the end of 2008, providing us with experienced Local Audit Co-ordinators throughout Scotland. The MSk Audit will now work closely with the orthopaedic Task and Finish Group auditing access to musculoskeletal services.

The Scottish Stroke Care Audit

The Scottish Executive has identified stroke care as a priority. Research on stroke care has advanced enormously in recent years. Implementing these advances in Scottish hospitals is seen as crucial to improving outcomes after stroke. The Scottish Stroke Care Audit (SSCA) is currently funded by Information Services Division of NHS Scotland to support the implementation of such advances. Previous funders include NHS QIS and the Scottish Government Health Department. The Audit is now an integral support for the care provided by every Scottish NHS Board. The NHS Boards use the Audit to evaluate their stroke care against National Standards and to drive improvements.

Scottish Audit of Intracranial Vascular Malformations (SAIVMS)

The purpose of the Scottish Audit of Intracranial Vascular Malformationsis is to monitor the quality of care, treatment, and outcomes for adults with intracranial vascular malformations (arteriovenous and cavernous malformations). SAIVMs does this by using multiple overlapping sources of case ascertainment to find every adult resident in Scotland, who is newly diagnosed with one of the malformations above, and enrolling them in a confidential audit. SAIVMs aims to include every adult in order to get a truly representative picture of what happens to people with your condition in Scotland. The audit involves adults who were first diagnosed in the years 1999-2003, and 2006 onwards. The audit is run by a team in the Department of Clinical Neurosciences in Edinburgh, and is overseen by a Steering Committee of consultants, who are representative of the relevant specialties at the four Scottish Neuroscience centres in Aberdeen, Dundee, Edinburgh, and Glasgow.

Scottish Audit of Surgical Mortality     (SASM) 

The Scottish Audit of Surgical Mortality is unique in the United Kingdom. It encompasses nearly all the surgical specialties and all except two eligible Consultant Surgeons and Anaesthetists in Scotland have agreed to participate. SASM identifies all deaths that occur in hospital under the care of a surgeon, whether an operation has taken place or not. SASM forms are completed by the relevant Surgeon and where appropriate Anaesthetist. The forms then undergo a peer review process carried out by virtually every practising clinician within the audited specialties on behalf of their colleagues. Over 1100 consultants participate and approximately 4,500 deaths are reviewed per year.

Scottish Hip Fracture Audit     (SHFA) 

Hip fracture is a common serious injury, which occurs predominately in the elderly. The care of hip fracture is multidisciplinary and resources vary across the country. The Scottish Hip Fracture Audit (SHFA) aims to improve hip fracture care by providing robust nationally comparable data on the care of hip fracture patients.

The audit started in 1993 in four hospitals, funded by the Clinical Resource Audit Group (CRAG). Since March 1999, the Information Services Division (ISD) of NHS National Services Scotland have met central co-ordinating costs. Whilst  data collection has historically been funded locally, temporary Scottish Government funding allowed full coverage of mainland hip-fracture operating hospitals in 2007 and 2008. New data collection stopped in December 2008 when the resource was transferred to an audit of Musculoskeletal Access (MSK).

Scottish Renal Registry (SRR) 

The Scottish Renal Registry is a national registry of patients with renal failure and other renal disorders in Scotland.

In 1991 the Scottish Renal Association obtained a grant from the Clinical Resource and Audit Group of the Scottish Office to establish the SRR. Information on all patients on renal replacement therapy (RRT) in Scotland is transferred, mostly by download from individual Renal Unit computers, to a central computer.

All NHS Renal Units contribute fully.
They compile reports for:

The SRR is part of the Scottish Renal Association.

Scottish Trauma Audit Group (STAG)  

The Scottish Trauma Audit Group (STAG) was set up in 1992 to audit Accident & Emergency services throughout Scotland. This audit ended in 2003.

Since then STAG has been working on a range of projects and are now in the final year of a national audit commissioned by NHS Quality Improvement Scotland: the Scottish Emergency Department Alcohol Audit (SEDAA). The aim of the audit is to describe the burden of disease and provide descriptive epidemiology for all alcohol-related presentations to the Emergency Departments in Scotland.

 Scottish Intensive Care Society Audit Group (SICSAG)   

The Scottish Intensive Care Society Audit Group (SICSAG) has maintained a national database of patients admitted to adult general Intensive Care Units (ICU) in Scotland since 1995. Detailed information is produced on the management of critically ill or injured patients. All Intensive Care Units and combined ICU/High Dependency Units (HDU) collect data and the audit has further expanded to include many High Dependency Units.

In October 2006, SICSAG joined Information Services Division (ISD), part of National Services Scotland (NSS).  Joining ISD has seen the audit benefiting from a significant increase in resources, with a dedicated SICSAG team, clinical support across Scotland from the National Audit Team and IT support from ISD.

Scottish ECT Accreditation Network (SEAN) 

Over the last six years SEAN has taken a central role in ensuring that there is a continued process of clinical audit and monitoring of all NHS ECT sites in Scotland.