Exploring the acceptance, utility and impact of an online clinical quality application (CQA) 

Clare Connor

Background to the Project

The musculoskeletal physiotherapy service within Aneurin Bevan University Heath Board (ABUHB) currently engages in a clinical quality paper audit of patient records. The audit tool measures compliance with legal documentation standards and the recording of clinical reasoning and decision making.  It is time consuming to complete and does not adequately represent the Health and Care Standards Wales (HCSW) that the service recognises as guiding principles for prudent high quality healthcare. Repeated audits have not led to behaviour change or service improvements.

The Project

The project is a pilot study with a cohort of physiotherapy clinicians to explore the acceptance, utility and impact of an online clinical quality application (CQA) that enables clinicians to rate elements of clinical interactions against the HCSW. Ratings are represented as a personal performance dashboard and can also be shared to inform service level performance data.

How this will be achieved

Project activity will comprise of the following stages:

  • Engagement:
  • With clinicians about current audit; HCSW and engagement with the project.
  • With service managers and leaders about quality information and reporting to complement performance dashboards.


  • Implementation
  • Pilot CQA within the musculoskeletal physiotherapy service of ABUHB.


  • Evaluation
  • Survey and interview clinicians who have piloted the CQA.
  • Review of clinical quality information generated through completion of the CQA during the pilot phase.


  • Dissemination
  • Communication of results with participants, service leads and through Bevan Exemplar platforms.


  • Follow-up
  • Business case development for integration of the application within physiotherapy and other NHS services.

Anticipated benefits

The project intends to develop a user-friendly online tool that that supports integration of clinical quality reporting into routine clinical practice as opposed to a periodic stand-alone task. This will facilitate continuous evaluation and reporting of clinical quality in daily practice to inform and improve the delivery of prudent healthcare within physiotherapy. This intervention has the potential for growth into all clinical areas of NHS Wales.