The Guide to Clinical Audits

What are the clinical audits?

A clinical audit is a systematic review of current health practices against existing agreed standards. It ensures that health care professionals provide the best level of care and focus on improving services when these standards are not achieved. 

How to perform an audit? ( The Audit Cycle)

Step 1: Identify a problem 

These are the clinical practices where improvements can be brought about. 

E.g. Whether surgeons are filling the surgical notes proforma properly or not.

Step 2: Find the standards for the existing problem

Standards are set by NICE, Royal colleges, or existing associations ( British Cardiovascular Society ). Find the standards related to the problem of interest. 

E.g. The royal college of surgeons guidelines for filling the surgical notes proforma. 

Step 3: Data collection 

This involves looking at the data where the problem could be identified. This can include patient notes and records.

E.g. Data collection after looking at filled post-operative surgical notes proformas of all operated patients in the last 1 month.

Step 4: Comparision to standards 

Summarising and analyzing the data, and comparing it with the set standards is the next step. 

E.g. Comparing your hospital’s surgical proforma filling with the standards set by the royal college of surgeons.

Step 5: Implementing change 

This includes providing training to staff, raising awareness about guidelines, improving the documentation, etc. 

E.g. 1. Organizing teaching sessions for surgeons for filling postoperative surgical notes proformas. 2. Putting out printed royal college guidelines around the theatre area to raise awareness.

Step 6: Re-assessment of implemented changes / re-audit/ closing the loop 

This includes repeating Step 3 and Step 4. 

If the standards are matched after re-auditing, the staff needs to ensure that the good practice is continued. 

If the standards are not met, Step 5 and Step 6 need to be performed again. 

How to begin?

1. Discuss with your clinical and educational supervisor about audit ideas
2. Discussion with your colleagues will help you as well and you can start an audit as a team
3. A very important source for radiology related audits is: RCR Audit Live
4. Speak to the audits section of the hospital and they will help you in the process of auditing

Useful Advice

1.Audits take a lot of time to complete so always start them way early before your training applications.

2.Collaboration with colleagues helps in performing multiple audits

3. Try to audit in the area of specialty you want to train in. This will show commitment to that specialty in your training application.

4. Closing loops help you score more in your training application

5. Present the audit results in a local, regional, national, or international meeting to score more

6. Learn all facts and figures/numbers about your audits when you go for your specialty interviews

7. In case you are not able to close the audit loop, don’t be discouraged as you will still score some points towards your training application

8. If you are not able to show positive changes after re-auditing, this does not mean that your audit was a waste of time. This will still mean that you have completed the full cycle of the audit. You will need to implement further changes to bring about a positive result, followed by a re-audit, in this case.