Clinical Audit: Tools and Techniques

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Clinical Audit Tools and Techniques

• Helen Betts
• Head of School
• Chair of CHIRAD

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What is Audit?

• A systematic and critical appraisal of the
  planning, delivery and evaluation of service/s in
  terms of efficiency, effectiveness and quality,
  within given resources.

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Research is concerned with discovering the right
thing to do audit with ensuring that it is done
right.
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Research or Audit into Nutrition?

• Determination of the populations consumption of
  fatty acids
• identification of actions to reduce fatty acid
  levels in local population
• investigation of the interaction between the
  effects of fatty acid and obesity
• implementation of actions to reduce coronary
  heart disease
• quantification of the level of fatty acid in
  prepared foods
• communication exercise to inform at risk
  patients of beneficial lifestyle changes

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Clinical audit involves systematically looking
at the procedures used for diagnosis, care and
treatment, examining how associated resources are
used and investigating the effect care has on the
outcomes and quality of life for the
patient.Department of HealthClinical Audit
Meeting and Improving Standards in Healthcare
(1993).
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Care is audited against defined standards derived
from research findings, professional expertise
and information about patient needs and
expectations.
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In concurrent audit, care is evaluated at the
time it is taking place. In retrospective audit,
care is evaluated after it has been completed.
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Reliability refers to the ability of an
instrument to measure the area of interest
consistently, in the same way across time and
with different assessors. Validity refers to the
ability of an instrument to measure what it is
intended to measure.
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Audits of the quality of care are normally
undertaken through a process of peer review the
review of a professionals practice by someone of
the same profession, against professionally
defined standards.
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The main methods used in audit of the quality of
care are

• Direct observation
• Checklists
• Documentation audit
• Questionnaires
• Interviews
• Case review

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You are a general practitioner organising an
audit of the home care for cardiac rehabilitation
patients. List all the professions who contribute
to this care, including those from other
organisations who input to the holistic programme
of home support.How could you receive their
observations?
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Items that would indicate clinical audit is
developing successfully

• It is undertaken by multi-professional healthcare
  teams
• it is focused on the patient
• it develops a culture of continuing evaluation
  and improvement of clinical effectiveness
  focusing on patient outcomes

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Benefits for professionals from a commitment to
quality assurance

• uphold professional/service standards
• increased job satisfaction
• opportunity for continual improvement
• fewer dissatisfied patients
• recognition/valuing of achievements
• productive use of time/effort
• acquisition of new skills/experience