Training activity information
Details
Perform an audit of critical care transfers and make recommendations for improving the practice
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Considerations
- Communication with the clinical team
- Information governance
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
What does success look like?
- Identify what is expected of you in relation to systematically reviewing a set of critical care transfers using predefined criteria, analysing the findings to identify areas for improvement, and formulating clear, actionable recommendations.
- Consider how the learning outcomes apply, specifically in relation to evaluating each patient transfer and understanding the importance of evaluating practice to drive continuous improvement.
- Discuss with your training officer to gain clarity of what is expected of you in relation to the audit criteria or methodology to be used, the expected format of the findings, and who the recommendations should be presented to.
What is your prior experience of this activity?
- Think about what you already know about the audit process, collecting and analysing data, or writing reports.
- Consider possible challenges you might face during the activity, such as accessing data, interpreting findings, identifying root causes of issues, or formulating realistic recommendations.
- Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if you need input from experienced colleagues or specialists regarding the clinical significance of audit findings or the feasibility of recommendations.
- Acknowledge how you feel about undertaking an audit – interested in process improvement or daunted by the task?
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as designing audit tools, collecting and analysing qualitative and quantitative data, identifying trends and patterns in practice, or writing persuasive recommendations.
- Identify the specific insights you hope to gain, for example, into common risks or challenges in critical care transfers, the effectiveness of current protocols, or the process of implementing change in clinical practice.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of finding data collection difficult or struggling to formulate recommendations.
- Identify important information you need to consider before embarking on the activity, such as having ethical approval or local permission to access the necessary data and familiarity with relevant guidelines (e.g., NICE, ICS, local) that might inform best practice benchmarks.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst reviewing transfer records or analysing data?
- Are you encountering situations such as:
- Incomplete or highly variable transfer records that challenge accurate data collection and analysis?
- Unexpected trends or severe deficiencies are identified in current practice that require urgent recommendations?
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to analysis by immediately adjusting the data review criteria to accommodate incomplete records?
- Consider the steps you are taking in the moment, such as:
- Immediately seeking clarification on the audit process or data interpretation from a supervisor
- Prioritising the documentation of findings that suggest significant deficiencies or require immediate recommendations
- How are you feeling in that moment? For instance, are you finding it difficult to interpret data or identify actionable recommendations? Is it affecting your confidence in formulating potential recommendations?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully analysing the information and identifying areas for improvement? Or are you needing support because the complexity of interpreting findings requires guidance from a supervisor?
- What are you learning as a result of the unexpected development? For example, are you mastering techniques for identifying root causes of issues? Or gaining insight into the importance of systematic audit methodologies?
On action
What happened?
- Begin by summarising the key steps you took when conducting the audit of critical care transfers, including data collection, analysis, and formulating recommendations.
- Consider specific events, actions, or interactions which felt important, such as identifying a significant trend suggesting poor communication in the transfer process or successfully formulating an actionable recommendation.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately revising the data review criteria to accommodate incomplete transfer records.
- How did you feel during this experience, e.g., challenged by interpreting findings or confident in the analytical process?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding systematic evaluation and improvement of practice. What strengths did you demonstrate, e.g., skill in data analysis and trend identification?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with complex statistical methods for analysis?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in critically evaluating practice or formulating actionable recommendations?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the interpretation of complex findings that required clinical input to address.
What will you take from the experience moving forward?
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving your approach to performing audits or evaluating practice.
- What will you do differently next time you approach evaluating critical care transfers, for instance, by proactively incorporating qualitative feedback from staff alongside quantitative data?
- Do you need to practise any aspect of the activity further, such as audit methodology, data analysis, or formulating effective recommendations for practice change?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of reviewing audit findings or participating in subsequent quality improvement initiatives since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent review (e.g., attending a risk meeting) provided further context on unexpected patient deterioration during transfers forced you to re-evaluate the conclusions or recommendations you formulated during your first attempt at the audit.
- Considering what you understand about data analysis, quality assurance, and continuous professional improvement now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your data collection, critical evaluation, and recommendation development based on further learning and experiences? For example, how you proactively contributed to SOP revisions related to documentation or transport procedures based on audit findings.
- Has discussing the findings of this audit, or the process of conducting audits, or the impact of poor documentation or ineffective communication with colleagues, supervisors, or at departmental meetings changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a systemic issue uncovered during an audit refined your understanding of the critical nature of reflective practice and quality improvement.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent quality improvement initiatives or reflective practice, contributed to your overall confidence and competence in quality assurance, critical evaluation, and developing evidence-based recommendations, particularly in preparing for assessments like CBDs or OCEs? For example, how your accumulated ability in data analysis and critical evaluation now enables you to evaluate practice, discuss incidents, or propose improvements during a Case-Based Discussion (CBD) assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to identifying and addressing areas for improvement in clinical practice? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer or Clinical Governance Lead immediately when audit findings suggest significant deficiencies or ethical issues that require action outside your direct authority.
- Looking holistically at your training journey, how has this initial transfer audit experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to evaluating each patient transfer, reflecting, and continuously improving professional skills? For example, how this foundational experience has supported your development in contributing to systemic improvement, critically evaluating practice, and applying data analysis skills.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 8 |
Outcome
Evaluate each patient transfer, reflecting and continuously improving professional skills. |