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What is a Clinical Audit?
The current accepted definition of clinical audit, endorsed by the National Institute of Clinical Excellence (NICE) in 2002 is “a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change”
The main benefits of clinical audit are that it identifies and promotes good practice and can lead to improvements in service delivery and outcomes for users, can provide the information needed to show others that your service is effective (and cost-effective) and thus ensure its development, provides opportunities for training and education, leads to the development of local guidelines and protocols, minimises error or harm to patients, reduces incidents/complaints and helps to ensure better use of resources and therefore increased efficiency and can improve working relationships, communication and liaison between staff and service users and between agencies.
The clinical audit process is known as the audit cycle (see diagram below). The main components of the audit cycle are: choose a topic, review current standards or agree standards, collect data on current practice, use data to make comparisons with standards, implement change to make improvements/benefits and re-audit to make sure that practice has improved.
Numerous topics are suitable and relevant for clinical audit and may be subdivided into three headings-Structure (the availability and organisation of resources and personnel), Process (the activities undertaken ie: what is done with the service’s resources) and Outcome (the effect of the activities on the health/well-being of the service user ie: changes for the individual which can be attributed to the clinical intervention they received). It is important to design a clinical audit project which will produce meaningful data and which can be completed within the budget and time available.
A clinical audit project is most likely to be successful and beneficial to service users if all of the key stakeholders are involved from the outset. These may include clinical and non-clinical staff providing the service, service users and those who support may be required to implement resultant changes in practice e.g. managers, trust board members. Roles and responsibilities within the team will need to be identified e.g. audit project lead, data collector.
In summary, the key points of clinical audit are that it aims to evaluate how close practice is to best practice and to identify ways of improving the quality of health care provided, aims to improve services, is usually led by service providers, is practice-based and is an ongoing process.
This page is maintained by the ACB National Clinical Biochemistry Audit Group