Analysis of the Use of Clinical Audits in Healthcare

Analysis of the Use of Clinical Audits in Healthc arIntroductionThe fiber of health feel for system is important to patients and the Government. High level of quality patient tending is the ultimate ingest in current health care practices. Service providers wish to deliver quality health care. Patients are the appropriate authority to determine whether the experience of health care is good. Effectiveness of care pertains to treatment and support and helps us to judge whether staffs are, doing the right thing in a right way to achieve best clinical outcomes (Patel, 2010).Audit of services is therefore very important to ensure that the clinical practices are adhered to repose captain standards and criteria. On the other hand health services are cogitateing on new information and friendship for advanced clinical practice. Research is cerebrate on this area in order to develop new practices and standards in health care system. Researches make changes to health care system by a dvance of knowledge and practice.The aim of this paper is to identify the difference between study and question and analyzing the benefits and limitations of audit.An overview of clinical audit.Audit derived from a Latin word, which means an official management of an organizations official accounts, by an independent body (Esposito Canton, 2014). Clinical audit is measuring the quality of patient care provided against a set well defines standards (Yorston Wormald, 2010). It go alongs staff a systemic way of looking into their practice and making improvements (Bennadi et al, 2014). Pioneer of clinical audit is Florence Nightingale whose work was searching reasons for high mortality in hospitals in 1850s. As per her assessment she reinforced cleanliness resulted in a drastic reduction in mortality rate. (Bennadi et al, 2010).Clinical audit Vs researchClinical audit and clinical research are entirely two different domains (Yorston Wormald, 2010). Clinical audit and research use ups some common components. Hence, there is a great deal of sway (Bennadi et al, 2014) in both terms. Audit compares the current clinical practice against well-defined standard/criteria, while research aims to define the characteristics of good practice on an occult land (Esposito Canton, 2014). Audit focused on evaluating the existing practice rather than discovering new information. Research is proven to be a larger scale get hold of that aims at establishing new practices or procedures to carry out a feature business in a different method. The focus of research is further ripening of existing practice. However, audit is monitoring a task to determine whether a particular task has undertaken as per set standards or criteria. Audits check the quality of the task or procedure (Bennadi et al, 2014). Audit is generally undertaken on a local basis however it is non limited to. (Hughes, 2005).Research aims to obtain new knowledge and to fill in any knowledge gaps.Research focus es on defining questions, making inclusion and exclusion criterias for people or problems to address and any growth clinical interventions or outcomes. Research methods for info collection and analysis that is applied are suitable to the topics for research (Strauss and Sackett, 1998, Hughes, 2005).Audit focuses on evaluating and analyzing the existing ones, not developing new practices (Difference between audit and research, 2014). But, research is aimed at developing new procedures to carry out in a more effective ways of carrying out. The focus on research is invention of new and further development of the old. The aim of an audit is to determine whether the standards and procedures are being followed and whether a task is completed properly. The aim of research is to add onto a body of research and to increase the amount of knowledge and learning available on a specific subject weigh (Difference between audit and research, 2014). Also, unlike audits that measure tasks and pr ocedures against a set out standard, research aims to test the hypothesis that is established by the researcher when beginning their experiments (Twycross reduce 2014).Research considered as a broader field in the field of health. Research requires lot of education and training. Researchers undergo research education and training as a part of their university programme of study to gain the foundation to conduct a research (Hughes, 2005). In contrast, audit emphasized on areas, which needs improvement. Audit put up undertake by anyone who is interested in a particular field and few receive education and training (Nettleton and Ireland, 2000).As per Hughess review, researchers involved in audit may benefit from approaches and techniques used to utensil findings that could potentially serve to fill the research-practice gap. Equally, those involved in audit will benefit from sampling techniques in research that can help to improve generalisability.Some similarities are identified be tween audit and research despite their differences. Audit and research starts with a question, require data to answer questions, and systematic approach (Twycross Shorten 2014), also both needs an investigator (Abbasi Heath, 2005).Difference between clinical audit and research is showed in the downstairs table, which was adapted from Bennadi et al, 2014 and Twycross Shorten 2014.Clinical auditResearch1Audit uses comparison of current clinical practiceResearch uses experimental methods such as randomised control trials.2Uses simple descriptive statistics to describe current practice standards.Uses a range of statistics to make inferences.3Audit relates to a particular area of attention.Research can be generalized to other populations.4Audit measures how well current practices are carried out against clinical policies and procedures.Research provided evidences for clinical policies and procedures.5It is practice based.Research is theory based practice.6Ongoing mathematical process o f quality assurance.One- off study.7No involvement of placebo treatment.May involve placebo treatment.8No changes involved in treatments of patients.Changes in treatment process.9Ethical approval is not required.Requires ethical approval.Benefits of clinical audit Audit conducted against set standards (Patel, 2010, Hughes, 2005) in a cyclic (Tsaloglidou, 2009, Hughes, 2005) process to ensure tasks carried out correctly. At the end of audit cycle auditors are able to address the areas of improvement and give feedback to the personnel who are involved in that particular task. Reaudit should carry out after an agreed period of implementing changes (Bennadi et al, 2014). Regular auditing alerts the health care professional the shortage (Patel, 2010) in health care delivery system. Also helps us to find out whether staffs are practicing as per standards set by the organization to achieve curative (Patel, 2010) patient care, identifies the factors causing failure to make improvements (Y orston Wormald, 2010). Therefore, organization can take actions to improve the area. Every time an audit cycle is completed there should be further improvement in patient care (Yorston and Wormald, 2010).Audit and feedback often used in health care setting to improve health care professional finishance. Discrepancies in health care practices against set standards are highlighted in clinical audit that helps to identify the practices needed to improve for quality care (Esposito Canton, 2014). Tsaloglidou explains that the observe for quality assurance and consistent delivery of high quality health services is the appropriate organization of the health center environment.The benefits of audit are patent for health care professionals as it reduces frustration, reduces organizational and clinical error, improves communications between professionals and secures effective medical defense through risk avoidance (Tsaloglidou, 2009). An audit is not only a incision for monitoring change in clinical practice, but also an educational tool (Tsaloglidou, 2009). As the improvement of health care is a cost-effective procedure, audit is revealed to be a very useful tool in managementLimitations of clinical auditEducational and training discipline has a huge impact on carrying out an effective audit. Audit should not consider as a light work. It does require knowledge, experience and skills to perform effectively because auditing required to choose appropriate question, analytical method and to be undertaken in a sensitive (Hughes, 2010) way. In general, audit tends to be an activity that be undertaken by anyone without proper training and analytical skills with an aim to improve clinical practice. Nevertheless, it is very important for the staff member who will take on to implement the audit cycle to have proper training, supervision and protected time (Mercel et al, 2006).Bowie et al identified that lack of protected time to conduct a clinical audit is a major disadvant age for health care professional. They have to do it within their own allocated clinical time. Therefore, it can potentially affect rank patient care when allocating clinical time for auditing. It is not possible to justify leaving wards understaffed and underfunded to undertake audit unless instant results are attained (Esposito Canton, 2014, Ellis et al, 2000, Hughes 2005). by and by it causes additional workload on key staff members when undertaking an audit (Collis, 2006, Johnston et al, 2000).Lack of support from management to make audit related improvements and changes with the view of providing quality patient care. Inadequate organizational monitoring of auditing activities and progress is a barrier to make changes in patient care. It can lead to frustration and distress on auditors (Bowie et al, 2012, Hughes, 2005).Indirect situational factors influence the success of auditing such as lack of time and resources, lack of supervision, lack of support from management, confli ct within multidisciplinary team, negative attitudes associated with audit process ((Travaglia Debono, 2009, Hughes, 2005).A systematic review of Cochrane study of 140 studies tested the effectiveness of clinical audit outcome against other methods of study such as meetings and distribution of printed materials. Results were variable. Audit outcome ranges from negative outcome to very positive effect. When the audit was effective, results range from small to moderate. Moreover, the study concluded that effectiveness of audit is likely greater, when baseline adherence to recommended practice is low. Therefore, there is no clear scientific evidence to support the real effectiveness of clinical audit (Esposito Canton, 2014, Ivers et al, 2014).ConclusionIn general, clinical audit considered as an effective and cost effective method for continuous quality improvement even though there are numerous limitations. Therefore, it is important to pay more attention to clinicians having trou ble in auditing and to determine what recommendations are made to make the audit more effective. In order to overcome the difficulties of audit, auditors need to be clear about the areas of clinical practice audited. In addition, it is very important to know the difference between audit and research to avoid hostile data collection while conducting an audit. Clearly, audit and research serve two distinctive purposes.ReferencesAbbasi, K., Heath, A. (2005). 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