|
Guiding principles for clinical audit.[4] |
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| Stage |
Recommendations |
Addressed within Cochrane Review? |
|
|
||
| Preparing for audit |
Securing stake-holder interest and involvement (e.g. professionals, patients or carers) |
No |
| Selection of appropriate topic, according to whether: |
||
| • Topic concerned is of high cost, volume, or risk to staff or users |
No |
|
| • Evidence of a serious quality problem |
Yes: effects greater if low baseline |
|
| • Good evidence available to inform quality standards |
No |
|
| • Amenability of problem to change |
No |
|
| • Potential for involvement in a national audit project |
No |
|
| • Topic is pertinent to national policy initiatives |
No |
|
| • Topic is a priority for the organisation |
No |
|
| Clear definition of purpose of audit, e.g. to improve or ensure the quality of care |
No |
|
| Provision of necessary support structures, i.e. |
||
| • Structured audit programme (committee structure, feedback mechanisms, and regular audit meetings) |
No |
|
| • Sufficient funding (audit staff, time of clinical staff, data collection, feedback) |
No |
|
| Identification of skills and people needed to carry out the audit |
No |
|
| Selecting criteria |
Definition of criteria (structure, process and outcome) |
No |
| Validity and potential to lead to improvements in care |
||
| • Evidence based |
No |
|
| • Related to important aspects of care |
No |
|
| • Measurable |
Yes (implicitly) |
|
| Measuring level of performance |
Planning data collection |
|
| • Definition of user group (and exceptions) |
Can't tell |
|
| • Definition of healthcare professionals involved |
Yes (implicitly) |
|
| • Definition of time period over which criteria apply |
Yes (implicitly) |
|
| Making improvements |
Identification of barriers to change |
No |
| Implementing change |
||
| • Establishing the right environment (at individual, team and organisational levels) |
No |
|
| • Considering external relationships (e.g. with patients or other agencies) |
No |
|
| • Use of other supporting interventions (e.g. educational outreach, reminders) and / or multifaceted interventions |
Yes: not supported by evidence |
|
| Sustaining improvement |
Monitoring and evaluating changes, e.g. continuing audit cycle, use of performance indicators |
No |
| • Appropriate organisational development (e.g. cultural change, adequate training) |
No |
|
| • Use of existing strategic, organisational or clinical frameworks |
No |
|
| • Leadership |
No |
|
Foy et al. BMC Health Services Research 2005 5:50 doi:10.1186/1472-6963-5-50 |
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