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Abstract

An audit is an indispensable quality assurance method for improving the quality of care and services. It allows for the independent gathering of data generated during clinical practice and service in a systematic and transparent way for review against agreed standards with the aim of identifying areas for improvement in the quality of care and service. This chapter is designed to equip and inspire medical and non-medical personnel at all levels, as well as medical students, to take the first steps towards the use of this important quality improvement tool. For this reason, detailed guidance is provided on a complete audit cycle ranging from how to select an audit topic and draw up criteria on how to conduct data analysis, create a report, implement the outcome and re-audit. To boost understanding, medical records are used as examples to demonstrate how each of the components of the audit cycle is designed and implemented. This chapter also explains how an audit could be used to evaluate health policies, design educational and training programmes and encourage the use of modern medicine. The barriers and enablers of effective audits in health care are also explained.

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References

  • Abdullahi AA (2011) Trends and challenges of traditional medicine in Africa. Afr J Tradit Complement Altern Med 8(s):115–123

    Google Scholar 

  • Adeleke IT, Adekanye AO, Onawola KA et al (2012) Data quality assessment in healthcare: a 365-day chart review of inpatients’ health records at a Nigerian tertiary hospital. J Am Med Inform Assoc 12:1039–1042

    Article  Google Scholar 

  • Baker R, Fraser RC (1995) Development of review criteria: linking guidelines and assessment of quality. BMJ 311(7001):370–373

    Article  Google Scholar 

  • Benjamin A (2008) Audit: how to do it in practice. BMJ 336(7655):1241–1245

    Article  Google Scholar 

  • Black N, Gruen R (2005) Understanding health services. Open University Press, Berkshire

    Google Scholar 

  • Bowling A (2009) Research methods in health investigating health and health services, 3rd edn. Open University Press, Maidenhead

    Google Scholar 

  • Bowling A (2014) Research methods in health – investigating health and health services, 4th edn. Open University Press, London

    Google Scholar 

  • Burgess R (ed) (2011) New principles of best practice in clinical audit. Radcliffe Publishing, Oxford

    Google Scholar 

  • Chan M (2015) Opening remarks at the internal forum on traditional medicine in China, Macao SAR. World Health Organisation. https//www.who.int/dg/speeches/2015/traditional-medicine/en/. Accessed 17 Sept 2015

  • Cheater FM, Keane M (1998) Nurses’ participation in audit: a regional study. Qual Health Care 7:27–36

    Article  Google Scholar 

  • Esposito P, Canton AD (2014) Clinical audit, a valuable tool to improve quality of care: general methodology and applications in nephrology. World J Nephrol 3(4):249–255

    Article  Google Scholar 

  • Ghosh R (2009) Clinical audit for doctors. Developmedica, Nottingham

    Google Scholar 

  • Grol R, Wensing M, Eccles M et al (eds) (2013) Improving patient care – the implementation of change of change in health care, 2nd edn. Wiley, West Sussex

    Google Scholar 

  • Hayes N (1994) Foundation of psychology. Routledge, London

    Google Scholar 

  • Hearnshaw HM, Harker RM, Cheater FM et al (2001) Expert consensus on the desirable characteristics of review criteria for improvement of health care quality. Qual Health Care 10(3):173–178

    Article  Google Scholar 

  • Hunyinbo KI, Fawole AO, Sotiloye OS et al (2008) Evaluation of criteria-based clinical audit in improving quality of obstetric care in a developing country hospital. Afr J Reprod Health 12(3):59–70

    Google Scholar 

  • Ibrahim SMH, Haroun HM, Ali HM et al (2012) Audit of acute asthma management at the paediatric emergency Department at Ward Madani Children’s Hospital Sudan. Sudan J Paediatr 12(1):104–114

    Google Scholar 

  • Institute of Medicine (1992) Guidelines for clinical practice: from development to use. National Academic Press, Washington DC

    Google Scholar 

  • International Organisation for Standardisation (2020) ISO 9001 Auditing Practices group guidance on: REMOTE AUDits. International Organisation for Standardisation (ISO) & International Accreditation Forum (IAF)

    Google Scholar 

  • Irvine D, Irvine S (1991) Making sense of audit. Radcliffe Medical Press, Oxford

    Google Scholar 

  • Johnston G, Crombie IK, Davies HTO (2000) Reviewing audit: barriers and facilitating factors for effective clinical audit. Qual Health Care 9:23–36

    Article  Google Scholar 

  • Jones B, Woodhead T (2015) Building the foundation for improvement how five UK trusts build quality improvement capacity at scale within their organisation. The Health Foundation, London

    Google Scholar 

  • Kediegile G, Madzimbamuto FD (2014) Obstacles faced when conducting a clinical audit in Botswana. South Afr J Anaesth Analg 20(2):127–131

    Google Scholar 

  • Kellett S, Newman DW, Hawes A (2001) The elusive final stages of the audit cycle: do we put results into action? J Clin Gov 9(4):187–191

    Google Scholar 

  • Levy B, Rockall T (2009) The role of clinical audit in clinical governance. Surgical 27(9):367–370

    Google Scholar 

  • Lockyer J (2003) Multisource feedback in the assessment of physician competencies. J Contin Educ Heal Prof 23(1):4–12

    Article  Google Scholar 

  • Mainz J (2003) Defining and classifying clinical indicators for quality improvement. Int J Qual Health Care 15(6):523–530

    Article  Google Scholar 

  • Martin V, Charlesworth J, Henderson E (2010) Managing in health and social care, 2nd edn. Routledge, New York

    Book  Google Scholar 

  • McCrea C (1999) Good clinical audit requires teamwork. In: Barker R, Hearnshaw H, Robertson N (eds) Implementing changes with clinical audit. Wiley, Chichester, pp 119–132

    Google Scholar 

  • Mclntyre N (1995) Evaluation in clinical practice: problems, precedents and principles. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2753.1995.tb00003.x. Accessed 15 Sept 2018

  • Mgaya AH, Litorp H, Kidanto HL et al (2016) Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting Tanzania. BMC Pregnancy Childbirth 16(343):1–10

    Google Scholar 

  • Mhame PP, Busia K, Kasilo OMJ (2010) Clinical practices of African traditional medicine. Afr Health Monitor 13:32–39

    Google Scholar 

  • Morrell C, Harvey G (2001) The clinical audit handbook – improving the quality of health care. Harcourt Publishers, Edinburgh

    Google Scholar 

  • National Institute for Clinical Excellence (2002) Principles for best practice in clinical audit. Radcliffe Medical Press, Oxon

    Google Scholar 

  • National Joint Steering Committee for Maternal Health Kenya (2002) Standards for maternal care in Kenya. The Professional Societies of Kenya and the United Kingdom. ISBN 9966-9755-1-9

    Google Scholar 

  • Oakland JS (1993) Total quality management. The route to improving performance, 2nd edn. Butterworth-Heinemann, Oxford

    Google Scholar 

  • Omigbodun AO (2004) Improving standards in practice through medical audit. Ann Ibadan Postgrad Med 1(2):23–26

    Google Scholar 

  • Osungbade KO, Oginni SA, Olumide EAA et al (2010) Clinical audit of intra-partum care at secondary health facilities in Nigeria. Niger J Clin Pract 13(2):210–214

    Google Scholar 

  • Paton JY, Ranmal R, Dudley J (2015) Clinical audit: still an important tool for improving healthcare. Arch Dis Child Educ Pract Ed 100(2):83–88

    Article  Google Scholar 

  • Pirkle CM, Dumont A, Zunzunegui M (2011) Criterion-based clinical audit to assess quality of obstetrical care in low-and middle-income countries: a systematic review. Int J Qual Health Care 23(4):456–463

    Article  Google Scholar 

  • Plsex PE (1999) Quality improvement methods in clinical medicine. Paediatrics 103(1):203–214

    Google Scholar 

  • Reberton N (1999) A systematic approach to managing change. In: Barker R, Hearnshaw H, Robertson N (eds) Implementing changes with clinical audit. Wiley, Chichester, pp 37–56

    Google Scholar 

  • Robertson N, Bker R, Hearnshaw H (1996) Changing the clinical behaviour of doctors: a psychological framework. Qual Health Care 5(1):51–54

    Article  Google Scholar 

  • Royal College of Nursing (1990) Quality patient care – the dynamic standard setting system. Scutari, Harrow

    Google Scholar 

  • Sale D (2005) Understanding clinical governance and quality assurance – making it happen. Palgrave McMillian, New York

    Google Scholar 

  • Sealey C (1999) Two common pitfalls in clinical audit: failing to complete the audit cycle and confusing audit with research. Br J Occup Ther 62(6):238–243

    Article  Google Scholar 

  • Secretary of State for Health, Wales, Northern Ireland and Scotland (1989) Working for patients. HMSO, London

    Google Scholar 

  • Shaw CD (1990) Criterion based audit. BMJ 300(6725):649–651

    Article  Google Scholar 

  • Swage T (2003) Clinical governance in health care practice. Elsevier, Edinburgh

    Google Scholar 

  • The Health Foundation (2016) A framework for measuring and monitoring safety: a practical guide to using a new framework for measuring and monitoring safety in the NHS. The Health Foundation, London. ISBN 978-1-906461-53-9

    Google Scholar 

  • University Hospitals Bristol NHS Foundation Trust (2021) How to: set an audit aim, objectives & standards. http://www.uhbristol.nhs.uk/media/2978983/4_how_to_aim_objectives___standards_v4.pdf. Accessed 28 Aug 2021

  • Waddell A, Brummitt B, Ovington C (2021) Remote auditing course. Paper presentation at Remote Auditing Course, Research Quality Association (RQA), Zoom online, 2–3 Feb 2021

    Google Scholar 

  • Weeks A, Ononge S (2001) Audit in maternity care: a better practice 1. Qual Forum 2(2):1–9

    Google Scholar 

  • Weeks AD, Alia G, Ononge S et al (2004) Introducing criteria based audit into Ugandan maternity units. Qual Saf Health Care 13:52–55

    Article  Google Scholar 

  • World Health Organisation Regional Office for Africa (2010). Regulation of traditional medicine in the WHO African Regions. https://www.aho.afro.who.int/en/ahm/issue/13/reports/regulation-traditional-medicine-who-african-region. Accessed 30 Nov 2016

  • Wright J, Hill P (2003) Clinical governance. Elsevier

    Google Scholar 

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Ente, C., Ukpe, M. (2022). Audit. In: Essentials for Quality and Safety Improvement in Health Care . Springer, Cham. https://doi.org/10.1007/978-3-030-92482-9_3

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  • DOI: https://doi.org/10.1007/978-3-030-92482-9_3

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