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Developing patient-friendly clinical audit reports blog
Further to the launch of HQIP's short guide 'How to develop a patient-friendly clinical audit report', this page will be a dedicated blog from clinical audit teams as they develop their patient-friendly clinical audit report.
Please see progress reports below from Diabetes UK and two of the NICOR cardiac projects, with updates from the National Joint Registry to follow shortly.
Producing an audit report for patients, blog entries:
- 25 March 2013 (SSNAP): 2012 results by region
- 25 February 2013 (NICOR): drawing board to publication
- 25 January 2013 (Diabetes UK): finalising the report
- 19 November 2012 (Diabetes UK): feedback and review
- 16 October 2012 (Diabetes UK): getting started
- 5 October 2012: welcome
25 March 2013: 2012 results by region for stroke survivors and their families
By: Kim Rezel, HQIP PPI Lead
Just a short note to say further patient-friendly reports are now available from the RCP for the Sentinel Stroke National Audit Programme (SSNAP). The national reports have been broken down into regions for stroke survivors and their families. Click here to take a look >
25 February 2013 (NICOR): drawing board to publication
By Lucia Gavalova, MINAP project manager and Polly Mitchell, National Heart Failure Audit Project Manager
Last autumn, we first met with HQIP communications manager James Thornton to talk about producing patient friendly reports for MINAP and the National Heart Failure Audit. We were a little hesitant it has to be said, as we worried the patient versions would simply duplicate information already published in annual audits, and just create more, unnecessary work for ourselves.
- See the MINAP patient report (pdf, February 2013)
- See the National Heart Failure Audit patient report (pdf, February 2013)
However, it quickly became clear that reports aimed at patients are quite a different kettle of fish from normal audit annual reports. Whereas annual reports are full to the brim with data, graphs and tables, the patient reports focus on explaining the role of clinical audit, main audit findings, and the implications and recommendations emerging from these results.
We were inspired by the idea that the information which our audits produce could be really useful to patients, helping them make sense of their treatment and make informed choices about their care.
We wanted to produce something which empowered patients, both by helping them understand how well cardiovascular disease is treated in England and Wales, and also by giving them the resources to question their local NHS services when they fail to meet evidence-based performance targets for the treatment of cardiovascular disease.
It was especially important to us that the reports were written with involvement from patient representatives. Our patient reps helped us with all aspects of the reports, from the way things were phrased and explained, to the way that data was displayed in graph and tables, right through to the eventual look and feel of the documents themselves.
Our patient reps were invaluable in showing us how to make the content relevant to patients, and how to express things in a clear and concise way without losing any of the complexity of the medical and technical concepts.
We want the reports to be read by as many patients as possible, so have tried to circulate them widely, getting them published on the websites of patient groups, charities and healthcare improvement bodies and featured in their newsletters and magazines. We are especially grateful to the UCL Public Engagement team and HQIP for their help and advice in distributing of the reports.
We're really proud of the finished products, which were published in January, so do take a look at them and let us know what you think: follow these links to access the MINAP patient report and the National Heart Failure Audit patient report.
MINAP and the National Heart Failure Audit are both managed by NICOR. They are part of HQIP's National Clinical Audit and Patient Outcomes Programme.
25 January 2013: Finalising the report
By Laura Fargher, National Diabetes Audit Engagement Manager, Diabetes UK
I'm glad to say that the National Diabetes Audit patient summary report has now been published! The last task was to make sure that we got the ‘look and feel' of the report right and, once again, I sought the advice or our key audience - people with diabetes. Initial drafts of the design were shared with the patient representatives for their comment and feedback. There was a unanimous view that a photograph on the front page wasn't a good idea, because it would only attract those people who related to the person in the photograph. For example, if it was a middle-aged white man, then it was unlikely to be picked up by a young woman. The other significant feedback was about the use of colour. They felt that using similar colours to Diabetes UK's brand colour would make it more recognisable as a diabetes-related document.
Taking on board their feedback, the final design uses a simple design with graphics, rather than photographs and the front cover is blue - similar, but different, to Diabetes UK. Surprisingly, the final document has ended up being 20 pages long. So much for a summary report! That said, the summary of the audit data is covered in the middle 8 pages - the rest includes a glossary, where to get further information etc.
Finally, the report - Are Diabetes Services in England measuring up - was published online in January 2013 and can be accessed on Diabetes UK's website. Hard copies of the report will follow and we plan to send a copy out through Diabetes UK's networks of people with diabetes, in particular Diabetes Voices - our volunteers who campaign for better health services and to each of our local support groups. We hope that the report will be read and used to highlight areas where diabetes services still need to be improved.
So, it is the end of a journey. It was a new journey for me and for most of those involved in the production of the report. I was met with a lot of enthusiasm, commitment and plenty of ideas! And I endeavoured to incorporate all this feedback into an accessible report that people with diabetes will find both interesting and useful.
Diabetes UK now plans to produce a patient summary for each of the national diabetes audit reports. Would I do it differently next time? I'd set tighter deadlines for people giving feedback and set myself tighter deadlines to finalise the report! Other than that, it's now a tried and tested process which seemed to work. However, the ‘proof of the pudding' will be in how the report is received and used. I welcome all feedback, so download a copy now and let me know what you think on laura.fargher@diabetes.org.uk.
19 November 2012: Producing an audit report for patients - feedback and review
By Laura Fargher, National Diabetes Audit Engagement Manager, Diabetes UK
The first draft of the National Diabetes Audit (NDA) patient summary report has now been reviewed by the patient representatives who are involved in the NDA. It was with much relief that most of the feedback received was positive. No radical changes requested and so no major re-writes required. Phew!
The feedback was mainly about the words used and some additional suggestions for the glossary. This was a timely reminder to me to keep the language used as simple as possible. Also, not to underestimate people's lack of knowledge of words that are commonly used in the world of audit or in the medical community.
The report has now been re-drafted and has been sent out for a second review by both the NDA Executive Board and a small group of patient representatives who have had no involvement in audit. At Diabetes UK, we have a network of service users who have volunteered to get involved in ad-hoc projects. Colleagues who support this network have been very helpful in identifying a group of service users to undertake the second review of the report.
We have asked the service users to specifically look at the language used whereas, the feedback requested from the Executive Board is around whether the report is aligned to strategic objectives and that its content reflects the NDA's key messages. The organisation responsible for data collection and analysis - the Health and Social Care Information Centre (HSCIC) - will also do one last check on the accuracy of the data presented in the report.
In parallel to the review work, I have been briefing a designer who will typeset, design and arrange for publication of the report. I was naive in thinking I would be able to handover this piece of work and forget about it until we had a sparkling new publication! The designer presented me with a whole raft of thought provoking questions:
- Will the report just be published online or will there be hard copies?
- How many copies do you want printed?
- What colours?
- Do you want to use pictures?
This may all seem relatively trivial compared to getting the content right, but how the report looks will have a major impact on the target audience. And clearly, we want to maximise its impact and usage. I've got another week until the final comments are returned. So, I have a bit of time to mull these questions over, so if anyone has any thoughts or advice on design please do get in touch.
I'll post a further update on the final stages of development of the patient summary report soon.
16 October 2012: Producing an audit report for patients - getting started
By Laura Fargher, National Diabetes Audit Engagement Manager, Diabetes UK
After months of deliberation and numerous conversations, I've finally put pen to paper and drafted a summary report for patients on the National Diabetes Audit (NDA) 2010-11.
The national NDA report was published in June 2012 and since then I've been talking to those involved in other audits that produce patient reports, and more importantly, to the patient representatives involved in the NDA.
Where do you start with translating data on around 2.2m people with diabetes, presented in 38 tables and 23 figures in a 47-page national report into something that makes sense for patients?!
At a meeting of the 15 NDA patient representatives in May, the general consensus was that the report needed to be a summary of key findings with signposting to where more detailed information and data can be found. Specific feedback included:
- Using fewer statistics and tables - data needs to be simplified, comparable and relevant
- Stating what care patients should expect
- Getting the reports reviewed by an audience who know very little about audit
Ok, so all of that makes sense and helped to guide my next steps. When the time came to put pen to paper (or should I say fingers to keyboard!), I faced a number of challenges.
In order to make the language used more understandable to a lay audience, I found I had to use more words rather than fewer! My aim was to produce a document no more than a couple of sides of A4, so I had a dilemma. Simplicity of language won the battle and the final draft has ended up being nine pages long.
Another challenge was how to translate complex data into something that is easy to interpret, without losing the integrity of the data. I didn't want to ‘dumb it down' so much that it diluted the message. I await feedback on the draft document as to whether I have managed to achieve this.
The draft was sent out to the 15 patient representatives last week and I have given them three weeks to give feedback. In order to maximise their input, I gave them some guidance on the kind of feedback that I needed from them - mainly around language used, readability and format.
I await their comments and will keep you posted about how that went and next steps in the development of the report.
By: Kim Rezel, HQIP PPI Lead
A warm welcome to this dedicated blog where we will be able to see how Diabetes UK develop their first patient-friendly report. New entries will be promoted via HQIP's regular eBulletin so if you haven't already signed up you can do so here.
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