Criteria of best practice in clinical audit

In our role in reinvigorating local and national work on clinical audit, one of our first tasks has been to secure agreement on what constitutes markers or indicators of good quality clinical audit, at both national and local level, conducted by both individuals and more commonly, by teams. The guidance takes into account the views of those active in clinical audit at all levels - clinicians, managers and clinical audit specialists.

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There is a huge volume of audit undertaken, some good, some very good, and some less so. This arises partly because there is no national, consensually agreed definition of the markers of quality in audit.

There are good examples of individual organisations or publications which have sought to define quality in audit. However there was no agreed definition that covers local and national practice in one simple set of standards.

This is something that has consistently been requested. People want to see such a standard for various purposes, not least of all simply for practitioners to make their own assessment of the quality of the work they are doing.

In producing this guidance HQIP looked to set an agreed, definitive, widely consulted, consensus standard for clinical audit quality which could then be used in other processes. These may include: revalidation of individual professionals; the allocation of funding for clinical audit; the offer of support, such as from clinical audit departments, for clinical audits proposed by provider teams; the accreditation or kite marking of clinical audits and clinical audit departments; the performance management of clinical audit teams; the commissioning of services; and regulation and performance management of healthcare.

The aims of the process were to be inclusive, by engaging people (including patients) from a range of disciplines, roles, and locations, as well as experience and orientation and use of clinical audit; to draw from the history and experience of clinical audit over the last forty years, starting from accepted and agreed definitions instead of re-inventing terminology; and be thorough and extensive, by consulting widely and in phases at greater levels of detail, which allowed participants to reflect on their original views given the subsequent contributions of others and re-contribute.

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