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At least 19 recordsLinked to original sources
PubMed1998

Clinical audit; who is auditing who?

Clinical audit is the principal means by which current clinical practice is improved. Doctors in training must gain positive experience of audit as juniors, so as to establish the importance of audit for future practice. Good audit requires involvement of doctors in training, a high level of participation and a leading role to be taken by the professional bodies. To examine the degree to which such criteria are met currently, the quality and prevalence of clinical audit, the participation of junior doctors in audit, and the preparedness of medical professional bodies' to guide audit were assessed. One hundred and twenty-six junior and senior house officers in three Edinburgh hospitals were administered questionnaires in person, whilst eight Royal Colleges, the British medical Association and the General Medical Council were assessed by the quality of their written guidelines for audit. The data showed that only thirteen out of twenty four specialties, which employed half the juniors, utilised clinical audit. Half of these audit programs were structured to lead to improved patient care. Surprisingly, only three out of ten professional bodies were able to provide good quality audit information. In conclusion, clinical audit is not universal practice and many existing audit programs are inappropriately structured. Commonly, doctors at all levels seemed unaware of the goals of clinical audit. In addition, the majority of professional bodies provide poor information, thereby impeding successful audit by doctors in training. Clinical audit will not succeed until such deficiencies are rectified.

Medical Audit↗
PubMed1999

Developing effective clinical audit.

Clinical audit received a mixed press when it was formalized as part of the health-care reforms in the early 1990's, and has continued to mixed reviews ever since. However, the latest governmental stipulations on clinical governance envisage a revitalized role for clinical audit. This paper advises on avoiding some of the pitfalls that await the unwary in developing effective clinical audit projects.

Data Collection↗
PubMed1994

Who needs clinical audit?

Clinical audit focuses on self--and, more importantly, peer assessments of the performance of practitioners and the service they provide to patients. Some practitioners may feel threatened by audit; however, when conducted as intended and viewed as a form of education, it may become recognised as an integral, cost-effective element of everyday clinical practice. This article highlights ways in which practitioners may increasingly appreciate the need to understand and apply clinical audit processes in their practice environments.

Clinical Competence↗
PubMed2005

Homeopathy service in a National Health Service community menopause clinic: audit of clinical outcomes.

Sheffield's National Health Service community menopause clinic has run a homeopathy service since 1998. The service provides an alternative treatment option for those women who cannot take hormone replacement therapy, do not want it, have found it ineffective, or have been advised to stop it. Patients receive homeopathic treatment (monthly consultations plus individualized homeopathic medicines) for up to six sessions. An audit was undertaken of all patients referred to this service between 2001 and 2003, in which patients completed the Measure Yourself Medical Outcome Profile. Patients reported significant benefit from the service. The greatest response was seen in those reporting headaches, vasomotor symptoms, emotional/psychological symptoms and tiredness/fatigue as their primary symptoms.

Aged↗
PubMed1998

Clinical audit at the heart of clinical effectiveness.

Clinical audit is becoming an increasingly sophisticated process now practised by a majority of clinicians. A crucial tool enabling clinicians to improve their care, it involves structured review against agreed standards. Clinical audit is a key component of each of the elements of clinical effectiveness enabling health-care interventions to achieve what is intended in the most beneficial way. A national lead in the development and integration of clinical audit into everyday practice is provided in England, with Department of Health support, by the professional bodies responsible for setting and maintaining clinical standards. The Department of Health recently published a White Paper setting out Government intentions for a greater focus on quality in health. Included in these plans is a National Institute for Clinical Excellence to support and coordinate national clinical guideline and clinical audit development programmes, as well as a greater focus on the quality, effectiveness and outcomes of care.

Clinical Competence↗
PubMed1998

Objective assessment of voice intervention: a clinical audit.

This clinical audit arose from research (Lockhart et al. 1997) which suggested timescales for the care episodes of diagnostically related groups of dysphonic clients, where SLT was directed at targeting the parameters of voice production most requiring change. The objectives of the audit were to examine current practice, compare it with the standards set and with the research findings, address any issues highlighted with regard to service delivery or staff training and to provide information to management on outcomes of care.

Diagnosis-Related Groups↗
PubMed2005

Is audit research? The relationships between clinical audit and social-research.

PURPOSE: Quality has an established history in health care. Audit, as a means of quality assessment, is well understood and the existing literature has identified links between audit and research processes. This paper reviews the relationships between audit and research processes, highlighting how audit can be improved through the principles and practice of social research. DESIGN/METHODOLOGY/APPROACH: The review begins by defining the audit process. It goes on to explore salient relationships between clinical audit and research, grouped into the following broad themes: ethical considerations, highlighting responsibilities towards others and the need for ethical review for audit; asking questions and using appropriate methods, emphasising transparency in audit methods; conceptual issues, including identifying problematic concepts, such as "satisfaction", and the importance of reflexivity within audit; emphasising research in context, highlighting the benefits of vignettes and action research; complementary methods, demonstrating improvements for the quality of findings; and training and multidisciplinary working, suggesting the need for closer relationships between researchers and clinical practitioners. FINDINGS: Audit processes cannot be considered research. Both audit and research processes serve distinct purposes. ORIGINALITY/VALUE: Attention to the principles of research when conducting audit are necessary to improve the quality of audit and, in turn, the quality of health care.

Health Services↗
PubMed1999

Clinical audit and the contribution of the laboratory to clinical outcome.

Medical and clinical audit are tools introduced in an attempt to assess clinical performance. Clinical audit implementation in practice should follow that of the audit and the learning cycles. Ideally, audit should assess the outcome of clinical care. However, many audit projects concentrate on the process of care, which is more amenable to review. One of the cornerstones of audit is the setting up of agreed standards of care. This takes the form of clinical practice guidelines derived, preferably from the outcome of randomised double-blind controlled trials as the basis of evidence-based medicine. The assessment of the contribution of the clinical laboratory to patient outcome could be seen as a further extension of clinical audit in the practice of laboratory medicine. Areas where this contribution may be assessed include validity and usefulness of diagnostic tests, the assessment of analytical goals in relation to patient outcome, variation in inter-laboratory performance and its effect on decision limits and whether any measurement or set of measurements contribute to improved outcome. The practice of clinical audit and the application of evidence-based medicine are seen as powerful educational tools, though there is much work to be done to assess their contribution to clinical outcome. Randomised clinical trials could form the basis for the assessment of the value and contribution of the laboratory to the outcome.

Evidence-Based Medicine↗
PubMed2003

Specialty audit leads--has this concept been effective in implementing clinical audit in an acute hospital?

Clinical audit has a pivotal role to play in improving the quality of patient care. As part of the programme for co-ordinating clinical audit across the trust each clinical area has a nominated doctor to lead and co-ordinate the audit programme in their specialty. This qualitative survey reviews the effectiveness of having specialty audit leads and reviews the progress that specialties have made in developing their audit programme. The semi-structured interviews with 30 clinical audit leads identified an uneven level of development of clinical audit across the trust, and demonstrated that dedicated time would be needed to make these posts more universally successful. Although one size will not fit all, the interviews highlighted some recurring themes--seeds of success--in functioning audit programmes.

Attitude of Health Personnel↗
PubMed2005

Linking clinical audit in general dental services to primary care trust clinical governance -- progress report of an approach used in Southend.

Clinical audit has been defined as the systematic, critical analysis of the quality of dental care, including the procedures and processes used for diagnosis, intervention and treatment, the use of resources and the resulting outcome and quality of life as assessed by both professionals and patients. The aim of clinical audit is to encourage dentists to self-examine different aspects of their practices, to implement improvements where the need is identified and to reexamine, from time to time, those areas that have been audited to ensure that a high quality of service is being maintained or further improved. Since 1st April 2001, all general dental practitioners (principals and assistants) working in the General Dental Services (GDS) have been required to participate in a rolling programme of at least 15 hours of clinical audit or peer review every three years. The first three-year cycle ended on 31st March 2004. By the end of December 2003, 96% of dentists had either under- taken or committed to undertake clinical audit/peer review activities. This initiative, in conjunction with the voluntary clinical audit and peer review schemes which preceded it, has provided opportunities for dentists and their practices to use these activities to assist in quality improvements in their practices, for the benefit of their patients. However, there are other methods for carrying out clinical audit and, in the NHS, there is a need to link it to clinical governance. This paper gives a progress report on an approach that has been piloted by Southend Primary Care Trust (PCT). It deals with the rationale for the project and outlines the methods used. It does not report results. These will follow in a subsequent paper.

Clinical Competence↗
PubMedDate not supplied

Clinical audit in practice.

Clinical audit exists to improve the quality of patient care and clinical practice. The authors state that, given the necessary time and resources, nurses can confidently audit their practice. The article also discusses the differences between audit and research and outlines some of the steps to ensure a successful audit.

Clinical Nursing Research↗
PubMed1997

Using clinical audit to promote evidence-based medicine and clinical effectiveness--an overview of one health authority's experience.

Health care purchasers are facing increasing pressure to make the best use of their limited resources and to purchase only those services known to be clinically effective. This paper describes one health authority's experience of promoting clinical effectiveness through clinical audit and clinical guidelines. It highlights the central role of public health physicians in working closely with clinicians on the one hand and managers on the other, to promote evidence-based medicine. The recent changes in the funding arrangements for audit have allowed purchases to have more say in what should be audited, and link audit and clinical effectiveness with contracts.

Cost-Benefit Analysis↗
PubMed2004

Clinical audit: introduction: getting started.

Clinical audit can benefit your practice and your patients. It is one of the pillars of clinical governance that will ensure that SAAD members deliver the best quality dental care. If you have experience of clinical audit that you would like to share with members, we would like to hear about it, so other members can learn from your experience.

Anesthesia, Dental↗
PubMed2000

The hidden cost of clinical audit: a questionnaire study of NHS staff.

OBJECTIVES: To determine the full cost of clinical audit in one health board area and extrapolate the result of Scotland. METHODS: A questionnaire was sent ot a representative sample of NHS staff to determine time spent on clinical audit. This was combined with cost data from clinical audit budgets and unit cost data for staff time. RESULTS: Seventy-two percent of staff participated in clinical audit at some point in time. Medical staff were significantly more likely to participate in audit than non medical staff (P <0.0001). Those who participated in clinical audit devoted only a small proportion of time to it. However, due to the high participation rates in clinical audit, this aggregated to a significant amount. In Forth Valley the total cost was estimated to be pound 1.72m (pound 1.37m-pound 2.10m) and in Scotland pound 36.3m (pound 29.6m-pound 44.0m). Staff time accounted for over 80% of the total cost of clinical audit. CONCLUSIONS: Clinical audit is widespread within the Scotish NHS and the total cost of staff time devoted to audit is substantial. Research is needed into the value of clinical audit and the potential cost implications of clinical governance need to be explicitly recognised.

Budgets↗