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Clinical Audit

A Clinical Audit is a quality improvement process used in healthcare to systematically review and improve patient care. It involves comparing current practice against established standards or guidelines, identifying areas where care could be improved, and implementing changes to enhance outcomes.

In simple terms, Clinical Audit asks the question:

"How are we performing against set standards of care?"

Constantly improving

The NHS uses clinical audit as a key tool to improve the quality, safety, and effectiveness of care. It helps ensure that patients receive care based on the best available evidence and that services are being delivered consistently and appropriately

Why do we "do" Clinical Audit?

We "do" Clinical Audit in order to know what is happening in a service; what is working well and where areas could be improved, and the results can help us highlight potential concerns.

Where do the standards we use come from?

The standards can come from local policies as well as national guidance like those from the National Institute for Clinical and Healthcare Excellence (NICE).

How can you involve patients and the public with audits and evaluations?

A simple way is to ask them to describe their experiences or opinions. This usually starts with surveys but can include interviews and focus groups.

How do we know which projects to carry out?

There are some national projects that we must do, whilst others are identified by the service or formulated at our annual Improvement Planning day.

Examples of Clinical Audits

Effective safe care and infection control

We routinely audit our inpatient care in across Hampshire and the Isle of Wight to provide assurance of effective care and act on any concerns. This can range from simple checks on wristbands, to more detailed checks on nutrition assessments, care plans and discharge reports.

Each inpatient ward will also have an infection control champion working with our central infection control team who will conduct regular audits to ensure we are following the latest guidelines.

Records, referrals and pathways

We provide a wide range of community services, many of which conduct audits. In one example, our physiotherapists have been able to show improvement and high levels of effectiveness in their record keeping for falls and the associated strength and balance therapy programme.

Like other services e.g. podiatry they have also used audit to drive improvement in the quality of referrals including self-referrals. Then when we introduced a new pathway for the care of people coming to GPs with back pain repeated audits have shown increased use and effectiveness.

Driving improvement using the audit cycle

Our specialist dental services conduct a wide range of audits, and in 2021 a more detailed audit on antibiotic prescribing during COVID demonstrated high quality, effective and improving care.

But sometimes, simple audits are great too. Their audit on the recording of parental consent is repeated each year, starting five years ago with 50% consent, rising each year and now achieving almost 100%. This shows how well managed audit cycles can drive continuous improvement.