Clinical audit

Clinical audit is part of clinical governance but can also be part of assessment. Clinical audit can help with assessing the implementation of EBVM in practice, for personal and practice-level professional improvement, and does not have to be led by the requirements for clinical governance.

What clinical audit is and what it isn’t

Clinical audit is (NICE 2002):

“A quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit measures and the implementation of change.”

The key component of clinical audit is that clinical performance is reviewed (or audited) to ensure that what should be done is being done. If what should be done is not being done, clinical audit provides a framework to enable improvements to be made. RCVS Knowledge have published a clinical audit toolkit which is designed within more of a clinical governance framework, and is useful as a reference for practitioners, remembering that clinical auditing can take place outside of clinical governance stipulations.

Clinical audit is not research, which can be defined as:

“A structured activity which is intended to provide new knowledge which is generalisable (i.e. of value to others in a similar situation) and intended for wider dissemination.” (UK Department of Health, 2002)

Clinical Audit Research
Purpose To improve patient care by testing clinical practice against set standards To provide new knowledge (e.g. to set or change clinical standards)
Methods Review of patient management or parts of management (e.g. diagnostic protocols, treatment options) using the principles of the clinical audit cycle Testing an hypothesis or addressing clearly defined questions, aims and objectives
Intervention Does not involve doing something to patients beyond routine clinical management May involve interventions / treatments / samples or investigations that would be considered additional to routine care
Analysis Simple statistics only (e.g. means, proportions, percentages) Requires data analysis (qualitative or quantitative)
Outcomes Leads to improvements in practice (if necessary) through development and implementation of action plans/strategies Improves knowledge

It should be remembered that research forms the basis of guidelines or standards to be audited, and so research may need to be undertaken first, by necessity, in some areas of veterinary medicine before a useful audit can take place. But if that research has been done, clinical audit can be undertaken and prove quite useful to clinical practice!