Clinical Audit

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What is Clinical Audit?

Clinical audit is a means by which you can compare your own processes and clinical practice to that of best practice. It enables you to identify areas of need, make any necessary changes, and thereby improve clinical outcomes and the quality of care that you provide.

Clinical audit provides a method for reflecting on and reviewing a wide range of different areas of clinical practice. Its aim is to stimulate and support quality improvement interventions and, through re-audit, to assess the impact of such interventions.

Why is Clinical Audit Important ?

Primarily, clinical audit helps to improve the quality of the service being offered to patients. Without some form of clinical audit, it is very difficult to know whether you are practicing effectively and even more difficult to demonstrate this to others (eg NHS purchasers). It identifies and promotes good practice, can provide information to show others that your service is effective, and can be a useful tool in identifying learning needs for CPD.

Clinical audit indicates an effort to reach higher professional standards and, importantly, is also a well established (and expected) core activity of responsible healthcare providers.

What can you audit and how much time does it take?

There are numerous topics that are suitable and relevant for clinical audit in chiropractic. In principle, anything in which you can identify best practice (known as “Standards”) can be measured by audit. These may be regulatory requirements (eg the GCC Standards of Proficiency or IR(ME)R), evidence-based clinical guidelines, a consensus among your colleagues of what is best practice, or even your own personal criteria for the standard of care that you aspire to provide, or your expectation of outcomes.

For some clinical audit projects, data collection, analysis and action plans can be carried out in an hour or so. In other cases, the process can takes a number of weeks or months. However, receptionists or other administrative staff are able to perform much of the data collection and processing, limiting the time commitment required from the chiropractor.

How do you do Clinical Audit ?

The process of carrying out a clinical audit cycle can be divided into a number of simple stages, the first being to identify the “standard” against which you are going to measure your own practice. This may be a clinical guideline, a statutory requirement or generally-recognised best practice. The method of data collection then needs to be designed which will enable you to measure your practice against the defined standard.

The first audit round is then performed (the data is collected). Once completed, the results are analysed to see how your results compare with the set standard. If necessary, practice modifications or other actions are then agreed and a time set for a re-evaluation.

In due course, the data is collected again as a second audit round is performed. The results are again compared with the standard as well as the results of the first audit. Conclusions should be written up, distributed to all involved (preferably the whole practice team) and these then contribute to the ongoing process of monitoring and improving standards of care.

RCC members should log in to access the clinical audit resources sub-menu where links to suggested topics for chiropractic clinical audit, and some simple audit toolkits, are provided. These can be used freely and adapted for personal requirements by College members. PRT candidates may find these toolkits particularly useful when satisfying the Clinical Audit requirement of the PRT programme.