Back to basics: Clinical Audit

Laura Watson, 3rd year medical student, University of Aberdeen

What is a clinical audit?

  • Clinical audit is a form of quality improvement

  • An audit involves identifying a standard of practice within a clinical environment and measuring whether or not a department is complying to the standard.

  • The data collected can then be used to provide evidence that improvement is required.

  • An improvement plan can be instigated and after a period of time, the standard can be re-audited to see if practice has improved. The process of re-auditing is called completing the audit cycle

  • An audit may be retrospective, which involves looking at data from the past e.g. via accessing case notes or prospective, where you may measure adherence to a standard over a set time e.g. compliance to the 5 moments for hand hygiene in a department over several hours

What is the audit cycle?

  • The audit cycle is the series of steps that you do in order to undertake an audit.

  • Click here to read an excellent article from BMJ careers which explains the whole audit cycle in more detail

How is audit different from research?

  • Audit measures clinical performance against a standard which is already defined

  • Research involves improving knowledge about a topic and involves testing a hypothesis

  • Click here to find out more about the differences in an article from the Regulation and Quality Improvement Authority

How would an audit benefit my career?

  • An audit is a great way to get to know your superiors in your local paediatrics department as well as learn more about a topic you’re interested in.

  • The above BMJ careers article also states that it is often a topic which arises at specialty interviews and can feature on job application forms

How would I go about organising an audit?

  • Contact a consultant in your local medical paediatrics or paediatric surgery department

  • Ask if there are any audits they or a trainee are carrying out that you could assist with or provide some ideas of your own (you could always take a look at the NICE or RCPCH guidelines for a topic you are interested in).

  • Your supervisor should be able to guide you through the process.

  • Quality Improvement or Clinical Governance in your NHS trust or board will need to be contacted and you may have to apply for permission to undertake your audit.

  • You may also need to sign a confidentiality agreement, and get permission to obtain any case notes.

  • You will need to anonymise and collect your data and then report back on your findings as to whether or not the standard is being met.

  • You would then attempt an improvement plan to be implemented.

  • You could re-audit again (timescale dependent) and complete the cycle.