Audit

An audit, in contrast to research, involves a process of evaluating a service (e.g. “how well is a GP practice recognising cancer red flag symptoms and referring via the 2-week-wait pathway?”). The service is compared against a standard (the optimal performance it should be at as defined by NICE guidelines etc.). If the service falls below the standard, then the reasons for this is analysed and changes are designed to improve the service. The changes are implemented and another “cycle of auditing” is done to see if the changes have improved the service such that it now meets the standard or better. This whole process is termed an audit. It is central to ongoing service improvement and takes place in every healthcare setting from GPs to hospital wards. Which means that there are loads of opportunities to get involved in them as a student! Here’s a stepwise approach to conducting an audit.

1.Measure service outcomes. 

Often this data will already be collected as part of normal patient care. You will often have to go back retrospectively to find the relevant data from computer systems etc.  

2.Compare to standard. 

The standard or guidleines can be found via the NICE (National Institute of Clinical Excellence) website, or via other sources such as research articles etc. 

3.Analyse reasons for sub-standard performance. 

This is often the most trickiest part, as you have to reason the causes for underperformance which will drive the next step.

4.Design and implement changes to improve. 

Once you’ve identified the causes, you can design certain changes that you’d like to implement. For example, promotion of cancer red flags via posters in GP clinics over the computer etc. 

5.Re-audit (re-measure service outcomes) to complete. 

This is essential to close the audit and complete it fully and determine if your changes, achieved the desired outcome.