P. 60

Many patients face adverse events during their hospital stay. The occurrence of adverse events varies from 3% to 17% of all hospital admissions worldwide. A significant proportion of these adverse events result in death (5–21%), of which half could be prevented. To obtain insight into safe hospital care, reliable data about the occurrence, causes, and preventability of adverse events have to be collected and made available. Commonly used methods for analyses of unsafe hospital care and improvement of patient safety include accreditation, external peer reviews, internal audits, patient safety systems, and performance indicators.
“Audit” is a Latin word, and the verb audio (‘hear’) indicates both active listening and the action of investigation and interrogation of the judiciary. Transferred to the English vocabulary “audit” takes on a meaning of “an official inspection of an organization’s accounts, typically by an independent body”[1].
The Clinical (or medical) audits were introduced to the NHS by the 1989 White Paper Working for Patients. Previously known as medical audit until a name change in the early 1990’s, clinical audit involves reviewing the delivery of healthcare to ensure that best practice is being carried out.
In 2016 NHS England published a new definition for clinical audit that reads as follows:
“Clinical audit is a way to find out if healthcare is being provided in line with standards and lets care providers and patients know where their service is doing well and where there could be improvements. The aim is to allow quality improvement to take place where it is most helpful and will improve outcomes for patients. Clinical audits can look at care nationwide (national clinical audits) and local clinical audits can also be performed locally in trusts, hospitals or GP practices anywhere healthcare is provided”.
The audit process is divided into 5 official steps and the cycle is only considered complete if all steps are performed. The five steps are as follows:
The success of a well thought out clinical audit strategy is measured by the degree of healthcare improvement and patient satisfaction. Many factors contribute to the success of clinical audit in an organisation. These include effective communication, staff engagement, empowerment and a sense of ownership. They also include the presence of adequate resources and support for training with a strong, dedicated audit team. The introduction of various incentives and rewards is proven to have positive effect.
The science of improvement should not threaten evidence-based medicine. To the contrary, it should complement it making it easier for the practising clinicians to make changes that will result in safer, more effective, efficient, equitable, timely and person-centred peri- operative care.
Dr Georgios Giannitopoulos
Consultant Anaesthetist, St George’s Hospital, London, UK

   58   59   60   61   62