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Table 3 Guiding principles for clinical audit.[4]

From: What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review

Stage Recommendations Addressed within Cochrane Review?
Preparing for audit Securing stake-holder interest and involvement (e.g. professionals, patients or carers) No
  Selection of appropriate topic, according to whether:  
  • Topic concerned is of high cost, volume, or risk to staff or users No
  • Evidence of a serious quality problem Yes: effects greater if low baseline
  • Good evidence available to inform quality standards No
  • Amenability of problem to change No
  • Potential for involvement in a national audit project No
  • Topic is pertinent to national policy initiatives No
  • Topic is a priority for the organisation No
  Clear definition of purpose of audit, e.g. to improve or ensure the quality of care No
  Provision of necessary support structures, i.e.  
  • Structured audit programme (committee structure, feedback mechanisms, and regular audit meetings) No
  • Sufficient funding (audit staff, time of clinical staff, data collection, feedback) No
  Identification of skills and people needed to carry out the audit No
Selecting criteria Definition of criteria (structure, process and outcome) No
  Validity and potential to lead to improvements in care  
  • Evidence based No
  • Related to important aspects of care No
  • Measurable Yes (implicitly)
Measuring level of performance Planning data collection  
  • Definition of user group (and exceptions) Can't tell
  • Definition of healthcare professionals involved Yes (implicitly)
  • Definition of time period over which criteria apply Yes (implicitly)
Making improvements Identification of barriers to change No
  Implementing change  
  • Establishing the right environment (at individual, team and organisational levels) No
  • Considering external relationships (e.g. with patients or other agencies) No
  • Use of other supporting interventions (e.g. educational outreach, reminders) and / or multifaceted interventions Yes: not supported by evidence
Sustaining improvement Monitoring and evaluating changes, e.g. continuing audit cycle, use of performance indicators No
  • Appropriate organisational development (e.g. cultural change, adequate training) No
  • Use of existing strategic, organisational or clinical frameworks No
  • Leadership No