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Requirement
Describe what a clinical audit is compared to research and it analyse the benefits and limitations of clinical audit.
Solution
INTRODUCTION
Clinical audit is regarded as a process that can be adopted in health and social care setting for the purpose of improving quality dimensions in the overall procedure. This basically aims to deliver optimum care to the patients through accessing different systematic reviews which are being developed for patient care (Savage, et al. 2015). Clinical audits seems to be a continuous process of improving quality of services and this can also involves inclusion of new tools and techniques to deliver optimum care to the patients.
The present research study has been made on defining the concept of clinical audit and how it supports in improving the care dimensions. In the research work, discussion is also included regarding benefits and challenges present in clinical auditing. The concept is also supported through theoretical and conceptual understanding; hence a clear distinction is being stated about research and clinical audits. Research is all about discovering the appropriate and accurate way to perform any task; however audit deals in ensuring that the task is done in right way. Furthermore, arguments are also made in respect of defining how clinical audit is useful for health and social care setting.
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LITERATURE REVIEW
As per the views of Sinuff, et al. (2015), clinical audit seems to be a valuable tool that improves quality of care by implementing numerous changes and modifications in the existing service dimensions. One of the major components of clinical auditing is reviewing the performance to analyse the areas where improvements are required. It is termed as a formal procedure which is being implied in health and social care setting for a number of reasons. Clinical auditing lies under the concept of clinical governance; hence it improves the overall standard of clinical practice. It also includes analysis of procedure used for diagnosis and treatment. At the same time, it focuses on ascertaining the use of resources in producing the best quality results for patients.
However, Areti Tsaloglidou, (2009), says that clinical auditing in an important part of clinical governance of a health care system which allows the care entity to adopt numerous tools to improve the quality of services. In clinical setting, issues related to quality seem to increase a lot as appropriate standards are not followed in accordance with the requirements. Thus, majorly the concept is being implemented to safeguard high standards of care in HSC by creating an environment in which health care dimensions can excel. There are three main attributes which are included in this concept such as recognizing the importance of high standards in care, developing transparency in responsibilities & managing accountability of such standards and constant execution of improvement in health care areas. Hence, it is expectedly a way of changing effectiveness of clinical services (Thornley & Quinn 2017).
The concept states clinical audit should include patients, clinicians and true professionals. Clinical audit forms different systems that aim to improve standards of clinical practice by meeting all the expected values made for HSC setting. The concept is also based on Audit cycle which demonstrates the steps that is involved in the process of auditing. Specially, it is adopted in health and social care area because it reveals the need for improvements which further defines how organizational efficiency can be improved.
Figure 1: Clinical audit is a part of clinical governance
Source: Research and professional development, (2016)
Comparatively, clinical audit is based on facts and standards which are being made and it aims to evaluate how close the practice is in reaching towards the expected standards. Therefore, it basically aims to improve the value of services by involving quality treatment. However, Miettunen & Metsälä (2017), defines about the research in clinical auditing by stating that clinical research contributes in establishing where HSC should involve in upholding the expected results.
THEORIES OF CLINICAL AUDIT
The main motive of the clinical audit is to take different type of initiatives for quality improvement purpose and this assists a lot in delivering best healthcare services to the patients (University Hospitals, Bristol, 2009). Concept of clinical audit is that it is viewed as a proper in-depth analysis that mainly focuses on enhancing the patient care and in turn different type of changes are implemented where the main motive behind the same is to bring improvement in the healthcare delivery. Further, as per this concept it is a well known fact that improvement in healthcare service is necessary required as patient have some sort of expectations from the healthcare practitioners and in this case it is necessary to undertake the clinical audit practice so that high quality services can be rendered to the patients.
In this concept various stages are present like it starts from selecting a topic, agreeing the overall standards of best practice, obtaining information, analyzing the data, feeding outcomes, discussing possible changes, implementing the changes etc (Sinuff, et al. 2015). All these stages are most crucial and all of them composes audit cycle. In short, the concept of clinical audit supports in analyzing the loopholes present in the internal operations due to which high quality services are not delivered to the patients and for improvement purpose various initiatives are taken that assists a lot in improving the quality of the service (Limb, et al. 2017).
Generally, research is all about findings the right things to do but the main motive of audit is to ensure where that particular activity has been done in proper manner or not. It is possible that within healthcare research may undertake any new treatment, adoption of different treatment groups with the motive of comparison Areti Tsaloglidou, (2009). On the other hand, the main motive of the clinical audit is to enhance the quality of local patient care along with the clinical outcomes through proper analysis and peer review of practices against evidence based standards.
The audit model is quite effective enough in understanding about the significance of audit in the clinical practice.
Figure 2: Model of clinical audit
Above shown are the main stages that are present in the audit model. Firstly planning takes place where control objectives are defined, review of data along with the documents takes place. Planning is done when any issue is faced that is associated with the clinical practice and main focus is on quality improvement against the standards set (Pant, et al. 2018). Second stage is performing where different actions are taken for enhancing the quality standards of the clinical practice. Generally the basic reasons behind undertaking clinical audit are due to complaints, adverse incident within the healthcare premises, or any other concerns (Limb, et al. 2017).
Next stage is communicating where all the healthcare practitioners communicates with each other regarding the best practice for quality improvement. Monitoring is the next stage where all the processes are monitored so as to identify whether any form of change is needed or not. Lastly quality assurance takes place where it is identified whether the quality level is up to the mark as per the standards or not (Horner, et al. 2014).
ARGUMENT AND ANALYSIS
Benefits of clinical audits
In the modern era, clinical audit is considered to be most significant and it plays vital role in every healthcare organization. As per view of Areti Tsaloglidou, (2009) numerous benefits of clinical audit are present where major one is enhancing quality of care. Further, it is a well known fact that every patient has some sort of expectation from the healthcare team or practitioners in relation with the quality. Therefore, clinical audit provides direct benefit to the patients where they are mainly involved in the entire process and it supports a lot in meeting with their expectations. Second main benefit of audit is that it helps in raising standards and in turn high standards are set for delivering best healthcare services to the patients.
Through clinical audit best practices are adopted for the welfare of the patients like development of effective appointment system, alteration in the discharge procedure etc. According to Hughes (2017), the healthcare professionals and other staff members are also benefitted through the clinical audit. This type of practice directly assists a lot in reducing the frustration and stress level among the provider of service and in turn leads to reduction in the chance of overall error. Any new system adopted or implemented through clinical audit is favorable for both healthcare practitioners and the patients.
Moreover, clinical audit improves the performance of overall healthcare organization and it is perceived by the patients as quality service provider. For healthcare professionals clinical audit matters a lot as through this they can easily develop their skills and in turn they are able to develop closer relationship with other team members. As per view of Thornley & Quinn (2017) another main benefit is that clinical audit assists a lot in enhancing the efficiency as the main aim of the audit is to enhance the quality and the healthcare firm is able to manage cost in the every possible manner. Clinical audit leads to efficient utilization of the available resources. Audit is regarded to be important for political reasons and it is one of the main part of the clinical governance also (Limb, et al. 2017). Furthermore it is a well known fact that government of every nation has developed strict guidelines where every healthcare firm is required to adopt best practice for quality improvement and this is only possible when audit is carried on continuous basis. So, these are the most significant benefits of clinical audits
Limitations of clinical audits
Clinical support and audit is not a universal process as it has recognized several downsides as well. The major barrier lies in this process is time constraint wherein most often the cycle does not give optimum outcomes. Healthcare professionals who are involved in clinical auditing always complain that they do not have adequate time to find out all the things; hence many things remain untouched for progress. Another problem that occurs is finance as auditing cannot be possible without having sufficient funds. Thus, problems occur when it is related to cost (Janssen, et al. 2017). The process of clinical audit requires appropriate use of information technology and unavailability of the same can impact the overall process. Sometimes, health care professionals do not have access to computerized facilities; hence lack of technical tools and systems can create problem in auditing process.
The practice of clinical auditing is always performed by expertise who have knowledge about technical support and work management. In many health care entities, there exists a lack of expertise in technical management which generates issues for people (Goldberg, et al, 2015). It is also identified that health care professionals believe that auditing is an obstacle to their autonomy and this shall not be a fair mode of appraisal. Nurses do not get ready to participate in multi-professional clinical auditing process as they feel it unsafe. Patient expects many things from the new care practices; hence this creates problems while implementing the plan of auditing. However, Savage, et al. (2015), states that while is considered as a tool to promote clinical effectiveness in practice, there is no such evidence that can prove it.
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Summing up the entire research study it can be said that value of professionalism in health care setting can be encouraged by having continuous monitoring and controlling of practices. This should be held on consistent basis which has wider scope of promoting clinical efficiency. The entire study carried out has supported in knowing the overall concept of clinical audit and it is considered to be quality improvement process. Firstly specific issue is identified within the clinical practice and on the basis of this proper plans are prepared for improvement purpose. Clinical audit assists a lot in enhancing the satisfaction level of the patients and in turn healthcare professionals are able to work efficiently and they can easily satisfy the actual need of the patients. Furthermore, one significant difference has been identified in between research and clinical audit where the former one is associated with identifying right things that needs to be done and later one helps in knowing whether it has been done properly or not.
REFERENCES
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Areti Tsaloglidou, R. N. (2009). Does Audit Improve the Quality of Care?. International Journal of Caring Sciences, 2(2), 65.
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Goldberg, I., Graham, S. L., Crowston, J. G., & d'Mellow, G. (2015). Clinical audit examining the impact of benzalkonium chloride?free anti?glaucoma medications on patients with symptoms of ocular surface disease. Clinical & experimental ophthalmology, 43(3), 214-220.
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Horner, K., O'Malley, L., Taylor, K., & Glenny, A. M. (2014). Guidelines for clinical use of CBCT: a review. Dentomaxillofacial Radiology, 44(1), 20140225.
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Hughes, K. (2017). How to do a clinical audit. Dental Nursing, 13(7), pp.336-337.
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Janssen, C. A., Tim, L. T. A., Voshaar, M. A. O., Vonkeman, H. E., & van de Laar, M. A. (2017). Quality of care in gout: a clinical audit on treating to the target with urate lowering therapy in real-world gout patients. Rheumatology international, 37(9), 1435-1440.
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Limb, C., Fowler, A., Gundogan, B., Koshy, K., & Agha, R. (2017). How to conduct a clinical audit and quality improvement project. International journal of surgery. Oncology, 2(6), e24.
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Miettunen, K., & Metsälä, E. (2017). Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units. Acta Radiologica, 58(6), 692-697.
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Pant, S., Tonse, R., Kannan, S., Moiyadi, A., Shetty, P., Epari, S., ... & Gupta, T. (2018). Impact of timing of radiotherapy on outcomes in atypical meningioma: a clinical audit. Practical Radiation Oncology.
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Research and professional development, (2016). Clinical Audit definition. [Online]. Accessed through http://www.rpd-research.org.uk/about.html. [Accessed on 24th March 2018].
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Savage, P., Sharkey, R., Kua, T., Papanastasopoulos, P., McDonald-Burrows, Z., Hassan, S., ... & Millington, H. (2015). Clinical characteristics and outcomes for patients with an initial emergency presentation of malignancy: A 15 month audit of patient level data. Cancer epidemiology, 39(1), 86-90.
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Sinuff, T., Muscedere, J., Rozmovitz, L., Dale, C. M., & Scales, D. C. (2015). A qualitative study of the variable effects of audit and feedback in the ICU. BMJ Qual Saf, bmjqs-2015.
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Thornley, P. & Quinn, A. (2017). A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training. Dentistry Journal, 5(4), p.31.
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University Hospitals, Bristol, (2009). What is Clinical Audit? [Online]. Accessed through http://www.uhbristol.nhs.uk/files/nhs-ubht/1%20What%20is%20Clinical%20Audit%20v3.pdf. [Accessed on 24th March 2018].
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