(MEDICAL) CLINICAL AUDIT

1. (MEDICAL) CLINICAL AUDIT Department of Public Health Faculty of Medicine UNPAD 2013

2. Learning objectives • Describe the definition of clinical practice audit (C2) • Describe the objective of clinical practice audit (C2) • Describe the benefit of clinical practice audit (C2) • Describe the phase in clinical practice audit (C2)

3. AUDIT Evaluation of data, documents and resources to check performance of systems meets specified standards.

4. Medical 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.”

5. From medical to clinical audit • The priority of audit was to involve all health professionals • Transition from uniprofessional to multidiscipline audit • Medical audit refer to audit carried out by medical doctor

6. Clinical Audit • “The process by which doctors, nurses and other health professionals regularly and systematically review and where necessary change their clinical practice”

7. The main objective of audit is to improve the effectiveness and efficiency of patient care

8. Clinical Audit

9. Three main constituents

10. Audit Cycle

11. Stage 1: Preparing for audit • Involving users • Selecting a topic • Defining the purpose • Planning

12. Selecting a topic:

13. Stage 2: Selection criteria • Defining criteria • Sources of evidence • Appraising the evidence

14. Target criteria and standard

15. Stage 3: Measuring level of performance • Planning data collection • Methods of data collection • Handling data

16. Stage 4: Making improvements • Identifying barriers to change • Implementing change

17. Identifying barriers to change • Fear • Lack of understanding • Low morale • Poor communication • Culture • Pushing too hard • Consensus not gained

18. Implementing Change: (systematic approach) • identification of local barriers to change • support of teamwork • use of a variety of specific methods

19. Stage 5: Sustaining improvement • Monitoring and evaluation • Re-audit • Maintaining and reinforcing improvement

20. Audit • Measures current practice against specific standards • Never experimental • Uses data in existence by virtue of practice • May require ethical approval • Aims to improve delivery of patient care

21. Research • Provides sound basis for medical audit • Involves experimental trials • Uses detailed data collection • Needs ethical approval and registration • Aims to add to body of scientific knowledge

22. reference • Fraser R. Lakhani M, Baker R. Evidence-Based audit in general practice. Butterworth. Oxford. 1999.