a6a9 Literature on the effectiveness of clinical audit

Literature about clinical audit

There is a range of academic literature about clinical audit, including regularly published studies of individual audits and overviews, and studies of the effectiveness of audit practice, sometimes as part of reviews of quality improvement in healthcare as a whole. This page provides links to this body of work.


Comparative reports

Some comparative reviews of quality improvement methods include consideration of clinical audit against other methodologies, but many do not. A good example of one that does is:

Ovretveit J (2005) What are the advantages and limitations of different quality and safety tools for health care? (World Health Organisation) 

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Digest of peer-reviewed clinical audit reports 

HQIP's digest of recently published studies of clinical audit practice in peer reviewed literature, where the article describes a cycle of audit or reviews audit policy, is found here.

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International reports (compliance)

The main international study of the former type, despite its title is:


Other compliance reports

Other reviews of the effectiveness of clinical audit at this level include:

  • Hearnshaw  H  et al. Are audits wasting resources by measuring the wrong things? A survey of methods used to select audit review criteria. Qual Saf Health Care, 2003. 12, p 24-8
  • Holdsworth J. Lessons from two decades of surgical audit . Clinical Governance: An International Journal. Vol 13, Number 2, 2008 , p115-127(13).
  • Hoolden JD. Systematic review of published multi-practice audits from British general practice.  J Eval Clin Pract  2004 May;10(2):p247-72.
  • Grimshaw J et al. Systematic reviews of the effectiveness of quality improvement strategies and programmes. Qual Saf Health Care. 2003 August; 12(4): p 298-303.
  • Foy R, et al.     What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review.     BMC Health Serv Res. 2005; 5: 50.
  • Johnston G  et al.   Reviewing audit: barriers and facilitating factors for effective clinical audit.  Qual Health Care 2000;9:p 23-36.

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Outcomes reports

As to the effect on outcomes, a large number of studies which sought to assess whether audit can be shown to lead to improved outcomes were reviewed by Loughlan for HQIP in 2009. A summary of this can be found here.

A longer study, which uses the work by Loughlan as the beginning of a discussion on the challenges of  evaluating the impact of quality improvement methods was published by HQIP in March 2011 and is available via this link.

'Challenges in evaluation of quality improvement methodologies; the example of clinical audit' View the study >>

A study by van de Veer et al (2010) reviews studies on the effect of registries, including projects which are or appear to be clinical audits, including on health outcomes as well as process improvements. This study identifies a number of studies where better outcomes have been achieved, but is clear that measurement alone without sustained feedback mechanisms is much more unlikely to bring benefits. (van de Veer S, De Keizer N, Ravelli A, Tenkink S and Jager K (2010) Improving quality of care. A systematic review on how medical registries provide information feedback to health care providers. IJMI 2010, 79. 305-323.

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Key historical documents about clinical audit in England

The following is a list of key published documents about clinical audit in England, and Wales prior to devolution:

Click here to download key historical documents about clinical audit in England >>

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Publishing studies of clinical audit practice

Getting studies of clinical audit published is challenging given the focus of many of the international journals. Don't let this discourage you! A list of potential journals covering aspects of policy, management and quality is listed below. See also our quarterly digest of published reports .

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Journals covering quality improvement and audit in health and social care

The following is a list of journals which cover quality improvement in health and social care, and which occasionally will cover clinical audit. There are of course many other journals for specific areas of clinical practice which will accept articles related to clinical audit. No recommendations are given for any journals on this list:

The American Journal of Medical Quality http://ajm.sagepub.com/

BMJ Quality and Safety:   http://qualitysafety.bmj.com/

British Journal of Clinical Governance:  http://www.emeraldinsight.com/journals.htm?issn=1466-4100

British Journal of Healthcare management:  http://www.bjhcm.co.uk/

Clinical Governance: an International Journal: http://www.emeraldinsight.com/products/journals/journals.htm?id=cgij  

Drug, healthcare and Patient Safety: http://www.dovepress.com/drug-healthcare-and-patient-safety-journal

The International Journal for Quality in Healthcare http://www.emeraldinsight.com/journals.htm?issn=0952-6862

The Joint Commission Journal of Quality and Patient Safety:   http://www.jcrinc.com/Periodicals/THE-JOINT-COMMISSION-JOURNAL-ON-QUALITY-AND-PATIENT-SAFETY/903/

The Journal of Clinical Governance: http://www.ingentaconnect.com/content/rmp/jcg

Journal of Health and Social Care Improvement:  http://www.wlv.ac.uk/default.aspx?page=15369

Journal for Healthcare quality:  http://www.nahq.org/Quality-Community/journal/jhq.html

Journal of Health Services Research and Policy: http://jhsrp.rsmjournals.com/

The Journal of Patient Safety:  http://journals.lww.com/journalpatientsafety/pages/default.aspx

Quality in Primary Care: http://www.radcliffe-oxford.com/journals/j10_quality_in_primary_care/

 

Specific to clinical audit, but not peer reviewed like the journals above:

On-line journal of clinical audits:  http://www.clinicalaudits.com/index.php/ojca

 

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