Clinical Audit In Healthcare

AUDIT AND CLINICAL AUDIT:
“Audit” is a Latin word, and the verb audio (‘hear’) indicates both active listening and the action of investigation and interrogation of the judiciary. Transferred to the English vocabulary “audit” takes on a meaning of “an official inspection of an organization’s accounts, typically by an independent body”(11) The term is now adays widely used in different settings (economic, business, etc.) referring to procedures aiming to ensure that the activities carried out for a purpose are consistent and effective for the achievement of objectives. Audit in healthcare is a process used by health professionals to assess, evaluate and improve care of patients in a systematic way and to measure current practice

Clinical audit is principally the measurement of practice against agreed standards and implementing change to ensure that all patients receive care to the same standard (NICE, 2002 (13) . It is important to stress that very few health care procedures involve just one professional discipline and that non-clinical staff such as receptionists, secretaries, porters, managers, etc play a vital role in the quality of the service provided. Clinical audit, therefore is usually a multi-disciplinary activity. Many clinical audits are also 'multi-sectoral'. that is they may involve health and social services" (NHS Executive. 1997).

HISTORY OF CLINICAL AUDIT :

Clinical audit has a history stretching back to the work of Florence Nightingale (1800s) and Ernest Codman (early 1900s).(14)
1800-1900 - Both Nightingale and Codman monitored mortality and morbidity rate respective in an institutions. Nightingale used an epidemiological method of review, monitoring rates of nosocomial infections in relation to standards of hygiene. Codman introduced the idea of systematic record review as a way of identifying errors.(14, 15)
1970 - In 1970s Royal Colleges started carrying out systematic audits on clinical practice.
1989 - Medical audit was introduced in the White Paper 'Working for Patients' which

But it does make use of research methodology in order to assess practice. Audit has similarities with research, but there are also many differences. Unlike research, audit does not necessarily extend the knowledge base of surgery but by critically analyzing surgical practice, audit aims to improve the quality of care. Because the primary purpose of an audit of surgical practice is not to promote scientific enquiry, the requirements and constraints of research do not necessarily apply. However, it can on occasion provide impetus for a related research project. Audit is about review of surgical performance with a view to improving quality of care within a team or practice. Audit data bases may be used to prove or disprove research hypotheses. This is called an ad hoc audit in the Clinician's Toolkit. The more data in the data base the more feasible it is to do this. It is therefore worth retaining audit data but care must be taken in preserving privacy in building larger databases particularly if more than one hospital is involved (RACS