Using the significant event audit model and patient interviews in assessing the quality of care

ISSN： 1475-9918

Source： The Journal of Clinical Governance, Vol.9, Iss.1, 2001-03, pp. : 13-19

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Abstract

Aim To consider the appropriateness and acceptability of the combination of significant event audit and semi-structured patient interviews as a tool to measure both practice and patient experiences of cancer care.Methodology Fifteen Warwickshire practices were asked to identify eight cases of breast, lung, colorectal or prostate cancer diagnosed during the previous two years. The patients undertook a semi-structured interview with a trained member of their local community health council (CHC). The practice team used the significant event audit model to evaluate the patient's care using a structured reporting tool. The results from both methods were integrated to identify common or conflicting issues about care.Results Practices completed significant event forms for 72% patients. Three practices (20%) completed eight significant event audits and three practices (20%) completed no significant event audits.The community health council interviewers reported less difficulty than anticipated during the interviews.The practice and patient perceptions concerning the source of support received by patients were incongruent in most stages of the patient journey.Conclusions Although the use of semi-structured interviews is labour intensive, patient involvement is useful, reliable and acceptable. The independence of the CHC as interviewers enhances this and should be incorporated into similar future work.Significant event audit is a powerful tool. The significant event audit report form proved easy to use but allowed comprehensive coverage of all aspects of care and presentation of results in a structured way. The technique can be applied in both local and wider contexts.The combination of semi-structured interviews and significant event audit enables comparison of the views of the patients and the providers of care. This is a powerful approach which allows equal weight to be given to the responses from both.