NICE define audit as “a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria ….’
Successive Governments have viewed audit as a handy means of measuring the provision of clinical services and performance, whilst assessing and driving up standards
Clinicians have not always shared their enthusiasm, sometimes seeing the process as time consuming, needless and confusing to undertake
However audit, when done properly, can be a key driver towards improving service provision, staffing levels and quality of care for patients.
So we need to understand how to plan and execute quality audits. When you think about it, it’s just like the layout of a clinical paper.
A good audit needs a good topic and objective.
This could target an area of practice where there are a large number of complaints, adverse incidents, increased spend or obvious gaps in the quality of patient care
Once the objective is identified the next step is to research the background to the subject and identify best practice documents, national guidelines or systematic reviews that relate to the subject.
If there are no guidelines to benchmark your service against, it is not an audit, it is a service evaluation and is classed as research.
Research allows us to produce best practice documents audit measures our service against the standards within these documents.
Best practice/ National guidelines will provide the criteria for the standards that the clinician must assess their service against. Data should be assessed against the key criteria that relates to the guidelines
Data collection should be succinct and easily understood. It should ideally include quantitative and qualitative data All stakeholders in the treatment should be consulted and understand the requirements of the data collection
It should stipulate who will collect the information when, where and how.
Ethical approval is required only if the treatment intervention is outside the normal treatment for the patient group studied.
The data analysis phase will look at the data and see if there are key trends.
Agreement between quantitative and qualitative analysis can be useful if the numerical information shows an area of improvement, the qualitative information can sometimes explain why.
Exception reporting should be included .
This process will identify key areas of improvement.
It is only after the re audit that a full audit report should be written up to show the results of the process. This ensures that the first audit acts as a benchmark and shows if any improvement has taken place..
Analysis of the results will result in an identification of issues and this will form the basis of the improvements to be implemented.
This is where there is discussion with all key stakeholders as to the key findings and recommendations takes place.
The next step is to implement the recommendations specified and after an agreed time re audit the service.