How to Perform a Clinical Audit

1. Creating Effective Clinical Audit
RAJISACON 2019, 22/09/2019 Samaresh Das

2. What is Clinical Audit?
“Clinical audit is a quality improvement process that seeks
to improve patient care & outcomes through systematic
review of care against explicit criteria…Where indicated,
changes are implemented…and further monitoring is used
to confirm improvement in healthcare delivery.”
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3. History of Clinical Audit
RAJISACON 2019, 22/09/2019

4. Why clinical audit is important?
• Improve the quality of the service being offered & to ensure
that what should be done is being done
• Effective/cost effectiveness
• Minimises error or harm to patients
• Provides opportunities for training & education
RAJISACON 2019, 22/09/2019

5. • Lead to the development of local guidelines & protocols
• Reduces the number of incidents and complaints
• Helps to ensure better use of resources & therefore increased
efficiency
• Can improve working relationships, communication and liaison
between staff, service users & agencies
Why clinical audit is important?
RAJISACON 2019, 22/09/2019

6. Why get involved in audit?
• To improve patient care
• Great way to show interest in a certain fields
• To learn many skills, e.g. teamwork, time management
• Can be presented at conferences, or for publications
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7. • Extra CV points for specialist training
• Part of annual appraisal and assessments
• Mandatory requirement for UK doctors to progress in training
Why to get involved in audit?
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8. Is Clinical Audit is a Research?
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9. Comparison Between Research & Audit
Research Audit
Creates new knowledge Care given from research
Based on hypothesis Measures against standards
Involves experiments, Ethical
approval
Usually never beyond clinical
management, Ethical approval usually
not required
Usually on large scale over
prolonged time
Relatively on small population over
short period
Results: generally published &
influencing the activity of clinical
practice
Results: relevant locally, influencing
the activity of local clinicians & team.
May be interest of wider population &
also published
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10. Difference between research and Audit
Research:
Audit:
Are you singing the right song?
Are you singing this song right?
RAJISACON 2019, 22/09/2019

11. Audit is not a………
A piece of
research/study
Data collection for
its own sake
A computer or number
crunching exercise
Cost cutting exercise
A witch-hunt
Remember....
RAJISACON 2019, 22/09/2019

12. Audit Cycle
Choose a Topic
(Reason for Audit)
Standards
Data
Collection
Data analysisImplementing
changes
Re-
Evaluate/
Review
The Audit
Cycle
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13. Stage 1: Choosing a Topic
RAJISACON 2019, 22/09/2019
Reason for Audit

14. Stage 2: Standards
RAJISACON 2019, 22/09/2019
Standards
What are we trying to
achieve

15. Audit standards
Audit standards should be SMART
• Specific : clear, unambiguous & one topic only
• Measurable : measured in a practical way
• Achievable : reasonable for staff to achieve
• Relevant : important to patients and staff
• Timescale : measured within a reasonable period
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16. Stage 3: Data Collection
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Data Collection
Are we achieving it?

17. Stage 4: Comparing performance with the standards
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Data analysis
if not, why are we not
achieving it?

18. Stage 5: Implementing changes
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Implementing changes
Doing somethings to
make things better

19. Stage 6 : Re-audit ; sustaining improvements
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Re-Evaluate/ Review
Have we made things
better?

20. This stage is critical to the successful outcome of an audit
process as it verifies whether the changes implemented have had
an effect and to see if further improvements are required to
achieve the standards of healthcare delivery
Stage 6 : Re-audit ; sustaining improvements
RAJISACON 2019, 22/09/2019

21. Compiling the audit report
The report does not have to be lengthy or complex. It includes
information on the following areas:
• Background to the topic
• Aims and objectives
• Standards
• Methodology
• Results
• Action plan/ Recommendation
• Re-audit plan
• Appendices-copy of audit proforma
• References
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22. RAJISACON 2019, 22/09/2019
Publication of Audit

23. RAJISACON 2019, 22/09/2019
For Suggestions/comments: drsamareshdas@gmail.com
samaresh.das@ydh.nhs.uk