Introduction
The ongoing drive for quality improvement (QI) is a cornerstone of modern general practice in the UK. Both the Royal College of General Practitioners (RCGP) and the Care Quality Commission (CQC) emphasise the importance of continuous learning and enhancement of patient care. However, a significant challenge for busy practices is the time and effort required to identify current best-practice standards, often buried within lengthy and numerous guidelines, when undertaking QI activities. This is where iatroX, an AI-powered information support tool, can be a helpful ally for GPs and practice teams, enabling efficient access to guideline information to support RCGP-aligned quality improvement cycles.
The quality improvement cycle and key information points
Most quality improvement activities, whether structured as a formal audit cycle or using Plan-Do-Study-Act (PDSA) cycles, involve several key stages. Rapid and easy access to current clinical guideline information is crucial at several points:
- Identifying areas for improvement and defining standards (Plan): When selecting a topic for audit or a QI project (e.g., management of recurrent UTIs in older adults, or asthma care in young adults), the first step is to understand what best practice looks like. This means referring to national guidelines from bodies like NICE (National Institute for Health and Care Excellence) or CKS (Clinical Knowledge Summaries).
- Developing interventions or changes (Plan/Do): If an audit reveals a gap between current practice and recommended standards, or if a proactive QI project aims to enhance care, the team needs to understand the guideline-recommended options to inform any changes to clinical pathways, prescribing habits, or patient information.
- Evaluating impact (Study): While iatroX doesn't measure performance, the standards derived from guidelines (accessed via tools like iatroX) are what you measure against.
iatroX supporting your practice's QI efforts
iatroX is designed to help your practice team quickly and efficiently find the specific guideline information needed to underpin your "evidence-based QI" activities.
Example audit: statin prescribing for primary prevention
Let's walk through a mini-case of a common primary care audit topic: optimising statin prescribing for the primary prevention of cardiovascular disease (CVD).
- Stage 1: Defining standards. The QI lead or practice manager needs to identify the current NICE or CKS recommendations for assessing CVD risk and initiating statins. Instead of lengthy searches, they could use iatroX with queries like: "NICE guidelines statin primary prevention" or "CKS QRISK3 criteria." iatroX helps quickly locate the relevant sections, outlining who should be assessed, what risk thresholds warrant intervention, and recommended statin choices. This forms the "gold standard" for the audit.
- Stage 2: Measuring performance. The practice would then collect data on current practice (e.g., from patient records) to compare against these NICE standards. (iatroX is not used for data collection itself).
- Stage 3: Implementing change. If the audit reveals, for example, that eligible patients are not consistently being offered statins, the clinical team might discuss barriers and agree on actions. During these discussions, team members could use iatroX to quickly refresh their knowledge on specific dosage, contraindications, or patient counselling points from the BNF (British National Formulary) or NICE, by searching "BNF atorvastatin dose" or "NICE shared decision making statins." This ensures any educational refreshers or new protocols are based on current recommendations.
Responding to new guidance or alerts
Quality improvement isn't just about planned audits. It's also about responding dynamically to new information.
- Drug alerts: If an MHRA drug safety alert is issued, or new significant side effects are highlighted for a commonly prescribed medication, practice teams can use iatroX to rapidly access the relevant BNF or MHRA information. This allows for swift review of affected patients and timely implementation of necessary changes, a key aspect of "CQC evidence" for safety.
- Updated guidelines: When major guidelines are updated (e.g., a new NICE guideline on diabetes management), iatroX can help the team quickly access and understand the key changes, facilitating discussions on how to incorporate these into practice protocols and ongoing QI work.
Aligning with RCGP, CQC, PCN, and ICB expectations
Engaging in robust QI is central to meeting "RCGP quality standards" and demonstrating effective governance to the CQC.
- Demonstrating well-led and safe practice: Using tools like iatroX to ensure easy access to, and awareness of, current national guidelines can be part of the evidence portfolio showing that a practice is well-led, safe, and responsive. It supports a culture where evidence-based medicine is actively applied.
- Supporting PCN and ICB quality metrics: Many Primary Care Networks (PCNs) and Integrated Care Boards (ICBs) have specific quality improvement dashboards and targets. Practice-level QI projects, informed by national guideline information accessed efficiently via tools like iatroX, can help ensure that local interventions are robustly evidence-based and contribute effectively to these broader quality agendas. For instance, if a PCN has a target for improving anticoagulation in atrial fibrillation, individual practices can use iatroX to quickly reference NICE/CKS guidelines on AF diagnosis, stroke risk assessment (e.g., CHA₂DS₂-VASc), and appropriate prescribing to inform their internal audits and improvement strategies.
Empowering the practice team (clinician-led QI)
It's crucial to emphasize that iatroX is an information retrieval tool – it provides rapid access to the 'what' (the guidelines and evidence). The 'how' of quality improvement – the planning, implementation, team engagement, critical analysis, and embedding of change – remains firmly practice-led. The decision-making, clinical judgment, and responsibility for QI outcomes are driven by the GPs, practice managers, nurses, and the wider practice team. iatroX simply aims to make one part of that complex process – accessing the foundational knowledge – more efficient.
Conclusion
In the demanding environment of UK general practice, dedicating time to quality improvement can be challenging. Efficient information retrieval tools like iatroX can play a valuable supporting role, helping clinical and administrative teams quickly access the national guideline information they need. This supports "GP practice improvement" by facilitating the definition of standards for "clinical audit primary care," informing evidence-based changes, and ultimately helping practices meet RCGP and CQC expectations for driving meaningful, RCGP-aligned quality improvements – always under the expert direction of the healthcare professionals involved.