The clinical audit process
Individuals and teams must demonstrate that their practice and procedures meet standards. Clinical audit is a tool for generating this evidence. Revalidation processes will expect pathologists to have information that demonstrates that they are taking part in high quality clinical audit activity.
What should I audit?
When thinking about topics to audit it may be helpful to consider the following:
- cost-effectiveness
- high risk practice
- commissioning
- new treatments or procedures
- national guidelines
- trust and laboratory priorities
- patients’ concerns
- local concerns.
Your audit does not have to be new. It is worth considering repeating audits to see if standards have been maintained or improved.
Above all consider if your idea for audit is realistic.
How do I set aims and objectives?
The aim describes what you want to achieve. It should measure the gap between ideal practice (determined from evidence, guidelines and standards) and actual practice.
The objectives describe what you are going to measure to show that your aim has been met. They should clearly state what your audit will investigate and how you will measure and make judgements. They should relate to your standards.
To ensure that your audit stays focused you need to state your aims and objectives.
How do I identify audit standards?
You must identify appropriate standards to compare practice against. Where possible you should use published national, regional or local standards.
If published standards do not exist you may need to develop your objectives and set a realistic standard to measure them against. To do this you should use research evidence, past audits and consensus opinion.
Completing the audit cycle (reaudit)
The audit cycle is now almost complete, but without reaudit it is impossible to judge if actions have been implemented. Reauditing a topic after changes have been made is an essential step in the audit cycle.
How do I choose the right method of collecting data?
You must plan the methodology in detail to consider the most effective and accurate way of collecting the data you require. You must decide whether you will look back at existing data (retrospective) or collect data as it happens (prospective). You must also ensure that your sample size is large enough to be representative of the population, condition or process you are auditing.
How do I analyse my data?
The purpose of data analysis is to find evidence to answer the questions posed by the audit objectives.
There are two main types of data analysis:
- Quantitative data: concerned with numerical or specific data.
- Qualitative data: usually descriptive rather than numerical.
What is the difference between audit and research?
Clinical audit is a way of finding out whether you are doing what you should be doing by asking if you are following guidelines and applying best practice.
Research evaluates practice or compares alternative practices, with the purpose of contributing to a body of knowledge by asking what you should be doing.
Please be clear that the clinical audit project you plan to undertake is not research.