IMPROVING PATIENT CARE – A GUIDE TO CLINICAL AUDIT
Clinical audit is a process where quality of patient care is analysed. It measures aspects of care related to diagnosis, therapeutics, use of resources and health outcomes. Audit and research differ. Research creates new knowledge which gives evidence for guidelines whereas audit looks at actual practice, if it conforms to accepted guidelines. Audit cycle consists of selecting a topic, setting criteria and standards, collecting of data, analyzing findings, making necessary changes and a reaudit after changes have been implemented. On completion of the audit an audit report is written with conclusions and the clinical audit is a systematic critical analysis of the quality of patient care. It is a professional tool that helps the family physician to look at his/her own practice and assess impact of patient care given. Is the care given good as it could be or good as it should be? An audit involves everyone in the team. It is merely a fact finding process rather than a fault finding one. It can be conducted as an internal or an external process.
The audit cycle is a continuous process where quality and effectiveness of patient care is measured against an accepted standard of high quality. Thereafter action is taken to bring patient care practices in accordance with these standards, to improve quality of patient care and health outcomes.
Audit measures all aspects related to patient care such as procedures used for diagnosis and treatment and the use of resources and outcomes. Hence regular audits will undoubtedly improve the quality of health.
Audit vs research
An audit measures the current practice against accepted standards of high quality. It is not an experiment of new procedures or a medication. Hence ethical clearance is not usually required. The findings are limited to the local practice.
In comparison research aims to generate new knowledge and the findings can be generalized to other populations. Research finds out the best thing to do or the best way to do. Therefore ethical clearance is mandatory.
Remember: “Research is concerned with discovering the right thing to do: Audit is ensuring it is done right” Smith R. Audit and Research. BMJ 1992; 305: 905 – 6.
Examples of a research and an audit
A research project to determine the causes for poor glycaemic control in diabetic patients
An audit to review if diabetic patients with poor glycaemic control are given proper education on their glycaemic control
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