Redesigning a Rural Physiotherapy Service’s Documentation Audit Process: Improving Quality whilst Promoting Honest & Meaningful Conversations

Purpose

The aim of this project is to capture the experiences of staff using a new documentation audit tool and to explore if embedding the audit process in to quarterly, one-to-one reviews improves quality and leads to further discussion related to professional matters and staff wellbeing.

91% of responders feel that the new documentation audit tool is easy to use
and they feel that the audit process has a direct impact on their record keeping, whereas only 45% of the responders felt that the traditional, annual audit process had a direct impact.
91% of responders feel that the 90 day reviews are the best time
to complete the documentation audit, whereas 9% would like to revert to the traditional model of an annual audit carried out by service leads.

Approach

The experiences of the staff using the audit tool was captured via a survey. The survey was designed on Smart Survey (smartsurvery.co.uk) and sent to all Physiotherapy staff to complete. The survey consisted of 6 statements, and asked staff to select one multiple choice answer for each statement using a Likert scale, with room for comments at the end.

Outcomes

There was a total of 17 responses, 6 of which were incomplete and subsequently excluded from the final results. The results showed that 91% of responders feel that the new documentation audit tool is easy to use and they feel that the audit process has a direct impact on their record keeping, whereas only 45% of the responders felt that the traditional, annual audit process had a direct impact. 73% of responders feel that doing the audit during 90 day reviews leads to wider discussion related to patient care and professional matters, and the remaining 27% remained neutral on this matter. 36% of responders agree that the new audit process lead to discussions related to the wellbeing of the member of staff being audited, whereas 36% disagreed with this statement. 27% of responders remained neutral. 91% of responders feel that the 90 day reviews are the best time to complete the documentation audit, whereas 9% would like to revert to the traditional model of an annual audit carried out by service leads.

Implications

The new audit process is having a greater impact on the clinical records that physiotherapists produce compared to the traditional, annual, documentation audit process. It is yet to be determined if the quality of notes being produced reflects this. It is also clear that staff value the one-to-one audit process and feel that this approach leads to wider discussion related to patient care and professional matters. This is a positive step forward in creating a supportive environment where staff feel they can have open and honest conversations. This work shows that there is potential for the new audit process to initiate and facilitate conversations related to the well-being of the Physiotherapist being audited, but this is not the key benefit being identified at this stage.

Further work is needed to assess whether the audit process does lead to conversations related to staff well-being. This can be explored in the years ahead by which time the new audit process will be embedded in the culture of the Physiotherapy service. When more documentation audits have been completed; individual outcomes may be useful in flagging potential professional and personal problems. The reliability of the results of this piece of work is limited by the low response rate and therefore may not reflect the opinions of the wider physiotherapy service.

Additional notes

This work was presented at Physiotherapy UK 2019