Question 1

Who should run this audit?

Accepted Answer

Acute medical, general medical, care of the elderly, oncology, palliative care, resuscitation, ward nursing and governance teams are all well placed. Include a project lead, senior clinical sponsor, resuscitation lead, palliative lead, frailty lead, nursing lead and governance / QI lead where possible.

Question 2

What permissions do I need?

Accepted Answer

Most trusts treat this as clinical audit / service evaluation and do not require ethics approval, but you must register the project with your local clinical audit or governance team before starting. Use only pseudonymised identifiers — do not enter NHS numbers, hospital numbers, names or dates of birth.

Question 3

How do I sample?

Accepted Answer

Use consecutive adult (≥ 16y) admissions with a DNACPR decision, ReSPECT plan or local treatment escalation plan — or where such documentation should reasonably have been considered — over a defined period. A sample of 30–50 per ward gives a reasonable point estimate; 60–100 across the trust supports comparative analysis and ward-level comparison.

Question 4

What does the tool measure?

Accepted Answer

Whether DNACPR / ReSPECT / TEP documentation is present, complete and clear; whether CPR and treatment escalation recommendations, ceiling of care, clinical rationale and senior responsibility are documented; whether patient capacity, patient involvement, best interests, ADRT / LPA, patient wishes and family / important-person communication are recorded; whether the plan is visible, communicated to the MDT, reviewed after clinical change, includes an out-of-hours deterioration plan and is carried forward at discharge where relevant.

Question 5

What happens after data collection?

Accepted Answer

The dashboard updates in real time. Use the Findings tab to interpret results, the Improvement tab to plan actions and PDSA cycles, and the Export centre to generate editable Word, PowerPoint, Excel, PDF and ARCP evidence outputs.

Question 6

Do I need to sign in to see the tool?

Accepted Answer

No. Authentication is handled at the main Lazomis QI website. Inside the tool you will already be in your authenticated workspace, or in demo mode with clearly labelled sample data.