J Grellier
Interface issues probably represent the most difficult areas where quality needs to be improved within the NHS. The issues relate to the way in which different cultures and working practices try to engage with each other. In 2000, the Clinical, Audit and Effectiveness Network (CAEN) in southeast London responded to the need for dynamic support in implementing change across the local interfaces with the commissioning of an interface audit programme. The objective of this programme is to facilitate the implementation of change, in discrete areas of patient care, across the interfaces of local healthcare organisations and theirpartner organisations. The local clinical governance resource group (CGRG), on behalf of the partner organisations, manages the programme. This study presents the findings of the evaluation of this programme (September 2000–June 2004), which includes five interface audit projects undertaken within the period. These are in the areas of stroke, coronary heart disease, antenatal education, deliberate self-harm and emergency contraception. All projects span two or more organisations, aremultidisciplinary and involve primary and secondary healthcare teams. The evaluation involves a retrospective analysis of the projects using quantitative and qualitative methods. Notwithstanding the very small sample size the findings of the evaluation provide significant insights that suggest modification of the project approach could enhance the programme’s potential as a model for implementing change in this complex and dynamic environment.
