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Research or Audit?. Nina Dunham R&D Manager. Introduction. What is Research? What is Audit? Why Research & Audit get confused? How the Trust processes research & audit. Research.

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research or audit

Research or Audit?

Nina Dunham

R&D Manager

introduction
Introduction
  • What is Research?
  • What is Audit?
  • Why Research & Audit get confused?
  • How the Trust processes research & audit
research
Research
  • A systematic investigation undertaken to discover facts or relationships and reach conclusions using scientifically sound methods.

(Hockey, 1996)

research1
Research
  • Purpose – To provide new knowledge in order to set or change standards
  • Methods – Randomised Trials etc…
  • Data Analysis – Extensive statistical analysis
  • Ethical & Trust Approval – Always required
  • Sample size – statistically powered calculation
research2
Research
  • Significance – Statistical difference (hypothesis driven)
  • Outcome – Improve knowledge
  • Results, publications – Generalisable, publishable in peer reviewed journals
  • Findings influence clinical practice as a whole
example of research
Example of Research
  • Purpose – comparing recovery rates in surgical procedure A compared to surgical procedure B in patients with diabetes over the age of 65
  • Method – Randomised Clinical Trial (RCT)
  • Data Analysis – Statistical analysis
  • Sample size – n = statistically powered calculation
  • Significance – statistical p value
example of research1
Example of Research
  • Outcome – Emperical Data which can be compared to existing knowledge and utilised in the decision making to use surgical procedure A as opposed to B
  • Results – Generalisable, results can influence clinical practice as a whole, accepted and published in peer reviewed medical journals
audit
Audit
  • A quality improvement process that seeks to improve patient care and outcomes -through systematic review of care - against explicit criteria and the implementation of change (NICE 2003)
audit1
Audit
  • Audits are cyclical – ie completion of audit cycle includes identifying areas of non-conformity with evidence based standards implementing practice changes to address these and then re-auditing standards of care
audit2
Audit
  • Purpose – Tests conformity with evidence based standards
  • Methods – Never involves allocation to different treatment groups
  • Data analysis – Simple statistical analysis eg descriptive and unadjusted comparisons such as t-tests
  • Ethic approval – not necessarily required
audit3
Audit
  • Sample size – sufficiently large case number to influence practice based on audit findings
  • Significance – Clinically meaningful performance indicators set against standards
  • Outcome – Improved clinical practice
  • Results – Audit methods and findings are usually locally implemented
example of audit
Example of Audit
  • Purpose – Surgical procedure A is recognised as a gold standard for patients over the age of 65 with diabetes
  • Method – Case note review
  • Data Analysis – Percentage of cases reviewed which meet the criteria
  • Sample size – not statistically powered
example of audit1
Example of Audit
  • Significant – acceptable adherence threshold may be set 100%, 90% or 80% dependent on practice being audited
  • Outcome – improved clinical practice
  • Results – Relevant to designated setting. Audit methods and findings may be of wider interested to be published.
similarities between research audit
Similarities between Research & Audit
  • Research & audit involve answering a specific question relating to quality of care
  • Both can be carried out either prospectively or retrospectively
  • Both involve careful sampling, questionnaire design and analysis of findings
  • Both activities should be professionally led
how the trust processes research audit
How the Trust processes Research & Audit
  • The NHS clinical effectiveness initiative explicitly links research and clinical audit,
  • “without research we won’t know what clinically effective practice is”
  • “without audit we won’t know whether it is being practised”
how the trust process research audit
How the Trust process Research & Audit
  • In order to conform with the Research Governance Framework all research projects must have Ethical & Trust approval
  • All Audit projects have to be processed through the Audit department using the CG1 form
how the trust process research audit1
How the Trust process Research & Audit

What happens when there is a difference of opinion?

  • Discussion between Ethics, Research & Audit dept
  • Research Executive Group
  • Medical Director
further information
Further Information
  • Research Dept – R&D Admin Porta Cabin, CHH
    • Research Staff
    • Intranet Pages
  • Audit Dept – Hull Royal Infirmary
    • Audit Staff
    • Intranet Pages
  • University Web Site
conclusion
Conclusion
  • What is Research?
  • What is Audit?
  • Why Research & Audit get confused?
  • How the Trust processes research & audit
  • Where to find further information