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
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
Baker R, Fraser RC (1995) Development of review criteria: linking guidelines and assessment of quality. BMJ 311(7001):370–373
Benjamin A (2008) Audit: how to do it in practice. BMJ 336(7655):1241–1245
Black N, Gruen R (2005) Understanding health services. Open University Press, Berkshire
Bowling A (2009) Research methods in health investigating health and health services, 3rd edn. Open University Press, Maidenhead
Bowling A (2014) Research methods in health – investigating health and health services, 4th edn. Open University Press, London
Burgess R (ed) (2011) New principles of best practice in clinical audit. Radcliffe Publishing, Oxford
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
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
Ghosh R (2009) Clinical audit for doctors. Developmedica, Nottingham
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
Hayes N (1994) Foundation of psychology. Routledge, London
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
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
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
Institute of Medicine (1992) Guidelines for clinical practice: from development to use. National Academic Press, Washington DC
International Organisation for Standardisation (2020) ISO 9001 Auditing Practices group guidance on: REMOTE AUDits. International Organisation for Standardisation (ISO) & International Accreditation Forum (IAF)
Irvine D, Irvine S (1991) Making sense of audit. Radcliffe Medical Press, Oxford
Johnston G, Crombie IK, Davies HTO (2000) Reviewing audit: barriers and facilitating factors for effective clinical audit. Qual Health Care 9:23–36
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
Kediegile G, Madzimbamuto FD (2014) Obstacles faced when conducting a clinical audit in Botswana. South Afr J Anaesth Analg 20(2):127–131
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
Levy B, Rockall T (2009) The role of clinical audit in clinical governance. Surgical 27(9):367–370
Lockyer J (2003) Multisource feedback in the assessment of physician competencies. J Contin Educ Heal Prof 23(1):4–12
Mainz J (2003) Defining and classifying clinical indicators for quality improvement. Int J Qual Health Care 15(6):523–530
Martin V, Charlesworth J, Henderson E (2010) Managing in health and social care, 2nd edn. Routledge, New York
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
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
Mhame PP, Busia K, Kasilo OMJ (2010) Clinical practices of African traditional medicine. Afr Health Monitor 13:32–39
Morrell C, Harvey G (2001) The clinical audit handbook – improving the quality of health care. Harcourt Publishers, Edinburgh
National Institute for Clinical Excellence (2002) Principles for best practice in clinical audit. Radcliffe Medical Press, Oxon
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
Oakland JS (1993) Total quality management. The route to improving performance, 2nd edn. Butterworth-Heinemann, Oxford
Omigbodun AO (2004) Improving standards in practice through medical audit. Ann Ibadan Postgrad Med 1(2):23–26
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
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
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
Plsex PE (1999) Quality improvement methods in clinical medicine. Paediatrics 103(1):203–214
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
Robertson N, Bker R, Hearnshaw H (1996) Changing the clinical behaviour of doctors: a psychological framework. Qual Health Care 5(1):51–54
Royal College of Nursing (1990) Quality patient care – the dynamic standard setting system. Scutari, Harrow
Sale D (2005) Understanding clinical governance and quality assurance – making it happen. Palgrave McMillian, New York
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
Secretary of State for Health, Wales, Northern Ireland and Scotland (1989) Working for patients. HMSO, London
Shaw CD (1990) Criterion based audit. BMJ 300(6725):649–651
Swage T (2003) Clinical governance in health care practice. Elsevier, Edinburgh
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
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
Weeks A, Ononge S (2001) Audit in maternity care: a better practice 1. Qual Forum 2(2):1–9
Weeks AD, Alia G, Ononge S et al (2004) Introducing criteria based audit into Ugandan maternity units. Qual Saf Health Care 13:52–55
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
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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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