Clinical Audit Tools and Techniques Helen Betts Head of School Chair of CHIRAD What is Audit A systematic and critical appraisal of the planning delivery and evaluation of service s

							Clinical Audit:
Tools and Techniques


Helen Betts
Head of School
Chair of CHIRAD
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.
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 population’s
    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” 4
    patients of beneficial lifestyle changes
“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 Health
Clinical Audit: Meeting and Improving Standards in
Healthcare (1993).                                 5
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.



                                      7
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 professional’s
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?                          11
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
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