Where to start in clinical audit?

Like most things in life, clinical audit is best learnt through practical experience. It is better to gain this experience with small, simple projects that are narrowly focussed rather than attempting to do everything all at once.

In essence, veterinarians will do some small-scale clinical research in the clinic to see how well they are performing. So you’ll collect some data, interpret that data in the context of your practice, and then decide if you ought to change anything. When the cycle is complete, you’ll decide when to do it again. The process is of limited value if you only do it once, but it doesn’t mean that you need to look at everything all the time in an ever spiralling auditing frenzy!

Choosing an area to audit

Start with something that:

  • has a clearly defined outcome or is clearly measurable;
  • you care about (or believe that some stakeholders care about);
  • is influenced by decisions made within the clinic (i.e. if you have no control over the outcome, there’s not point auditing it!).

Good areas for a first audit are:

  • peri-operative deaths;
  • suspected nosocomial infections;
  • post-surgical complications for common elective surgeries (e.g. neutering).

Performing the audit

The steps that are involved are:

  1. Set a timetable or schedule for the audit, and identify who will do the work.
  2. Collect the data/information.
  3. Assess the findings, and decide on actions.
  4. Decide when to do it again (i.e. when to go back to Step 1.).