The GCC registrant survey provides interesting insights into the level of monitoring taking place across chiropractic practices. According to the findings, 55% of survey respondents working in clinical practice monitor performance in at least one of their workplaces, but the research reveals that a third of clinical practices are not undertaking any kind of performance monitoring.
The results aren’t surprising but, as a profession, I would argue that we need to do better. Performance monitoring should be an essential part of running a modern quality practice. Monitoring provides valuable data to support our work and ensure we continue to provide high standards of patient care.
There are a range of different performance monitoring measures available. The research found that the majority of practices who have some form of performance monitoring in place are recording patient numbers (80%) and patient satisfaction (75%).
But patient attendance and satisfaction alone are not effective performance measures. While it is important that patients are satisfied with their experience these measures provide little information about the provision of care. Ultimately, improvement in condition is more important to the patient.
Measuring patient outcomes
As healthcare professionals our primary goal is to deliver the most appropriate care to our patients and help them manage their health. To do this effectively we need outcome data.
Patient Reported Outcome Measures (PROMS) enable practitioners to understand a patient’s health from their perspective. Through PROMS we gain insights into how a patient is responding to treatment and identify any aspects of care that need improvement. We can use the data to take any necessary steps to modernise our practices and ensure we are consistently providing high levels of care to our patients.
In my view, PROMS is the most effective way of monitoring and it is also one of the easiest. Lack of time is often cited as a reason for not implementing any performance monitoring, but it doesn’t need to be a difficult or time-consuming process.
There are many resources, including software, freely available to help practices measure patient outcomes. After the initial set-up, these tools can be incorporated into normal practice administration and require little time commitment.
They provide a fantastic amount of anonymous data which can be shared with other patients, chiropractors and other healthcare professionals. This data contributes to the wider understanding of how chiropractors treat patients, thus giving greater credibility to the chiropractic profession.
Clinical care audits
Conducting regular clinical care audits is not only part of running a practice, but they are also part of being a sound healthcare professional.
A clinical care audit helps to assess if patient care is being delivered in line with recognised guidance and is meeting the appropriate standards. The aim is to achieve quality improvement and better outcomes for patients.
Time and organisation can be a barrier to undertaking an audit but to remember to start small. Clinical care audits do not have to audit everything. For example, an audit could assess blood pressure measurement in patients with headaches. Consider the criteria to set the audit by and review patient notes to audit how patients have been treated. Explore whether the treatment was in line with guidance and met professional standards or whether steps need to be taken to improve patient care.
Clinicians can use the results of an audit to make statements about their practice which can be backed up with evidence.
There are lots of useful resources available to support monitoring, for example, the Royal College of Chiropractors has useful information on clinical care audits and the Versus Arthritis Campaign also has guidance on the clinical audit process.
It’s important that all chiropractors find the time for performance monitoring. In short, governance is not an option.