Table 4 Eight recommendation to optimise audits

Equal focus

 Strive for the same goal together. Boards demonstrate and auditees feel that the audit is a chance to improve.

Learning culture

 Create a culture in which employees are open for feedback and quality is part of the job. Crew Resource Management (CRM) training helps teams to speak up and improves communication within team.

Audit on board’s agenda

 Include audit results in the planning and control cycle of the hospital. And boards should discuss the progress of planned improvement actions based on the audit results with the head of the departments.

Post-audit support

 Help health care professionals to improve their health care based on the audit results. Provide support for departments to implement improvements after the audit.

Quality assurance of auditors

 The quality of an audit depends on the quality of the auditors. Train and evaluate individual competences and skills.

Peer-to-peer approach

 An audit team should be multidisciplinary. Include nurses and medical specialists in the audit team.

Soft signals in audit

 Give feedback to departments regarding signals indicating potential safety problems originating from more diffuse social and cultural aspects of healthcare.

Audit tailoring

 Adjust content of audit to needs and relevance of auditees. Needs should be inventoried before an audit takes place with a self-assessment.