Clinical Audit

Outline

• Background

• What is clinical Audit

• Principles of clinical audit

• Stages of clinical audit

 Background
 Monitoring of patient outcomes
 king Hammurabi of Babylon,
 punishments for clinicians for poor performance.

 The first clinical audit is

 Florence Nightingale during the Crimean war of 1853-5, when
improvement of standards following an “ audit” on cleanliness
 remarkably reduced the mortality rates in hospital patients

(Lokuarachchi, 2009)
 Introduction
Background
 Audit- derives from the Latin word audire which means "to hear”

 Monitoring of patient outcomes

 king Hammurabi of Babylon,
 punishments for clinicians for poor performance.

 first recorded medical audit was done by Sinan Ibnu Thabit, Chief
Physician of Baghdad dan Abu Batiha al-Muhtasib

 One of the first clinical audits ever undertaken was during the Crimean
War of 1853-1855-Florence Nightingale

 Another famous advocate of clinical audit was Ernest Codman- surgical

audit 1912

 English NHS- white paper, in 1993

 Background cont’d
 there had been individual and team works done in the past
two decades
 Prior times- adverse occurrence review, clinical incidence
monitoring, peer review
 Clinical audit projects in Gonder Hospital (pioneer)
 Formally incorporated in 2016- HSTQ
 Clinical audit
 A quality improvement process seeks to improve patient care and outcomes
 through systematic review of care against explicit criteria and
 the implementation of change.
 Aspects of the structure, processes, and outcomes of care are selected and
systematically evaluated against explicit criteria.
 Where indicated, changes are implemented at an individual, team, or service
level and further monitoring is used to confirm improvement in healthcare
delivery.
National Institute for Clinical Excellence
 Clinical Audit

 Clinical audit vs Research

 Clinical audit
 No Name
 No Shame
 No Blame
Clinical audit cycle
Audit Cycle
 Stage One: preparing for audit

 Step 1: involving stakeholders

 Step 2: Determine the audit topic

 Step 3: Planning the audit delivery

 Set the aim/objectives of the audit
 Equip the audit team with the necessary
knowledge and skills
 Providing the necessary structures
 Stage One: cont’d

 design

 data issues

 Implementability

 Encouragement
 Stage Two: Selecting criteria

 Clinical guideline

 Standards

 Criteria
 National audit
 Local audit
 Stage Three: Measuring level of
performance
 Data collection plan
 Tools and techniques

 Sampling
Stage Four: making improvements

 Change ideas

 Creating enabling environment

 Implementing
Stage Five: sustaining
improvement
 Monitoring and evaluating changes
 Re-Audit

 Clinical performance indictors

Thank you!