Audit

Under the terms of the Level 1 and Level 2 contract for methadone services, participating GPs agree to an audit of their methadone patients. The audit assesses their compliance with best practice as determined by the ICGP guidelines 'Working with Opiate Users in the Primary Care Setting'. Hard copies of this document are available on request from Niamh Killeen, niamh.killeen@icgp.ie

Why Audit?

"The overall aim of clinical audit is to improve patient outcomes by improving professional practice and the general quality of services delivered. This is achieved through a continuous process where healthcare professionals review patient standards against agreed standards and make changes, where necessary, to meet those standards. The audit is then repeated to see if the changes have been made and the quality of patient care improved."

(Practical Clinical Audit Handbook, 2005 Pg 3)

Methadone Treatment Protocol (MTP) Audit

Aim: To improve patient care in the implementation of the MTP in GP settings by measuring compliance with documentation guidelines and changing practice where necessary.

(Audit Cycle from the Royal College of Pathologists)

Ethics and Audit

While research projects always require ethical approval, clinical audit usually does not. Clinical audit, however, must be carried out ethically. The MTP audit process has been passed by the Research and Ethics committee of the ICGP. The clinical audit facilitator does not take away any information from the practice that would identify the service user and when the GP audit report is discussed at the ARG, the GP is referred to by a code number. GPs sign consent for the audit to be carried out.

Audit Forms

For your information, the following forms are completed during the audit:

• 2.1 Consent Form - The consent form is signed by both the nurse and the GP. This form is a statement of confidentiality as well as consent for review of the records of patients under the Methadone Treatment Protocol.
• 2.2 Patient List Form - This form is used to enable the data to be recorded anonymously. The clinical audit facilitator randomly chooses 10 patients from the list of patients registered with the GP. The GP keeps this for reference for responding to any queries which might arise as a result of the audit.
• 2.3 Practice Profile Form - This proforma paints a picture of the practice and how it operates in relation to the Methadone Treatment Protocol.
• 2.4 Audit Criteria Form - This form outlines the evidence required for the care of opiate dependent persons as parts of the MTP. These criteria are based on the Best Practice Guidelines.
• 2.5 Patient Audit Report - This form is sent to the GP in the invite letter. It highlights all the information which the audit nurse collects for each patient.
• 2.6 Audit Report - This information is collated and an audit report is generated which will be sent back to the GP with any questions that the clinical audit facilitator may anticipate before the audit review group meeting. This also gives the GP the opportunity to respond.
• 2.7 Common issues arising from audit.

Documents

 2.7 Common Issues Arising from Audit (2.7_Audit_Common_Issues.pdf | 79 KB)

 

 2.6 Audit Report (2.6_Audit_Report.pdf | 231 KB)

 

 2.5 Patient Audit Report (2.5_Patient_Audit_Report.pdf | 316 KB)

 

 2.4 Audit Criteria Form (Audit_Criteria_and_Standards_-_January_2012.pdf | 408 KB)

 

 2.3 Practice Profile Form (2.3_Practice_Profile.pdf | 243 KB)

 

 2.2 Patient List Form (2.2_Patient_List_Form.pdf | 86 KB)

 

 2.1 Consent Form (2.1_Consent_Form.pdf | 249 KB)