Clinical Audit Case Study

AUTHOR: OLOFU FATIMA OKACHE

BSc PUBLIC HEALTH, 4TH YEAR

SUPERVISOR: Dr. GODÉNY SÁNDOR

Róza Ádány MD PhD DSc

Head of the Department

2017

INTRODUCTION

WHAT IS CLINICAL AUDIT?

Clinical audit is the area of quality assurance that is concerned with comparing clinical processes to pre-set standards for care that have been derived from evidence-based medicine. This is to ensure that these processes are in line with the standards and where necessary, implement changes to further improve the quality of care. (Esposito and Canton 2014) The structure, process and outcome are the three categories under which the comparisons are made. (Scrivener, et al. 2002)

BRIEF HISTORY OF CLINICAL AUDIT

Clinical audit dates back as far as 1853 during the

For the purpose of this study however, more focus will be placed on the Donabedian model as it is the most popularly used framework among health care quality specialists due to it’s applicability in various situations. (McDonald, et al. 2007)

THE DONABEDIAN MODEL

Donabedian’s model is a three-part framework that focuses on structure, process and outcome, assuming that these three components are interrelated and that structure affects process, and process affects outcome. Although, there are some disadvantages of this model which include the difficulty of establishing the relationship between the components and also the problem of overlaps between parts of the components, it is still the most widely used framework in clinical audit. (Shan, et al. 2011) (Glickman, et al. 2007)

• STRUCTURE

This mostly refers to the attributes of the care giving facilities ranging from the available infrastructure to educational qualifications/competencies of health care providers, method of operations and administrative

Identifying areas that need change

5. Formulating strategies for change

6. Implementing changes where necessary

7. Assessing the effect of the change against the standards.

The audit process can start anywhere between stages 1 – 4 and the audit can be repeated continuously to form a cycle if the standards have still not been met by the end of the audit process or the standards are increased due to fulfilment of the previous standards. (Redfern and Norman 1996)

DEMING’S PDSA CYCLE (Farrell and Abreu 2012)

PDSA is an acronym for plan, do, study and act. The PDSA cycle is a method for quality involvement that consists of the four stages mentioned above, which are continuously repeated to form a cycle.

• PLAN

This is the part of Deming’s cycle that has to do with assessing prevailing conditions and defining the process, collecting data, putting consumer needs and expectations into consideration and identifying problem areas. Based on the identified problem areas, solutions and strategies to tackle the problems will also be developed in this stage.

• DO

In this stage, the plans are executed as experiments in small groups to test their efficacy. Data from these experiments are usually collected and stored.

•