Even the best guidelines or SOP’s are only useful if they are followed. Audit is the way to test compliance. Clinical Audit should be part of a continuous improvement process or quality improvement cycle consisting of the following steps:

Choose the target

Plan to audit a topic that is clinically important, with evidence of room for improvement such as errors, adverse events or reactions, large variations in practice or patient complaints (downloadable below)

Define the aim

There should be a clear ‘audit question’ (or questions), just as any research proposal should start with a concise statement of the research question or hypothesis to be tested (downloadable below).

Select the criteria

Local criteria (developed by the hospital’s clinicians) should be used as the basis for audit. Such locally developed guidelines should be based on current national recommendations. These take account of the best available evidence.

Define the methods

Decide what is to be observed or measured, how the data will be collected, quality controlled, analysed, and presented.

Implement an action plan for improvement

Decide what will be done to improve practice if the audit shows that improvement is needed, plan and implement (downloadable below).

Repeat the audit

Test for evidence that practice has improved.