A Quality Improvement Activity for revalidation requires you to demonstrate that you regularly participate in activities that review and evaluate the quality of your work. Where possible, the activity should demonstrate an outcome, or change. If you do not work in clinical practice, you should take part in quality improvement activities which are relevant to your work. Quality improvement activities could take a variety of forms, for instance:
Clinical Audit – or an equivalent quality improvement exercise, should measure the care with which an individual doctor has been directly involved. Administrative reviews of case notes alone (as frequently undertaken by contract providers) is in itself principally aligned to quality control and further additional evidence of quality improvement will be required.
Case Review or discussion – would take the form of a documented account of interesting or challenging cases that a doctor has discussed with a peer, another specialist or within a multi-disciplinary team.
Audit and monitor – the effectiveness of a teaching programme, for instance.
Evaluate the impact – and effectiveness of a piece of health policy, or management practice, for instance.
Quality improvement activities should take place at least once every revalidation cycle, however, it would depend on the nature of the activity. For instance, participation in full national clinical audit might be appropriate once per revalidation cycle, whereas a case review would be expected more regularly. The exact frequency of your quality improvement activities should be discussed with your appraiser.
When discussing quality improvement activity at your appraisal, you will need to prove that you have evaluated and reflected on the results of your activity or audit. You should also prove that you have taken appropriate action arising from the outcome of your results. Finally, following the audit or activity, if an improvement has occurred, you should demonstrate that it is being maintained, this may require a repeat of the activity or a re-audit, after an appropriate period of time.