Clinical Audit

Clinical audit is essentially a quality improvement process; it aims to improve patient care, and the outcomes of care. Audit is achieved by conducting a systematic review of care which may have been set against pre-determined standards and criteria; suitable changes can be implemented, and the effect of those changes can be re-evaluated.

What is the difference between audit and research?

Research and audit are often confused; some of the differences between audit and research are explained in the table below.

RESEARCH	AUDIT
May involve experiments based on a hypothesis.	Never involves experiments and involves measuring against pre-existing standards.
It is a systematic investigation.	It is a systematic review of practice
It may involve random allocation.	It never involves random allocation.
There may be extra disturbance to patients.	There is little disturbance to patients.
It could be a new treatment.	It never involves a completely new treatment.
Creates new knowledge about effectiveness of treatment approaches	Answers the question "are we following best practice?"
May involve experiments on patients.	Patients continue to experience their normal treatment management.
It is usually a lengthy process and involves large numbers of patients.	It is usually carried out involving a small number of patients and within a short time span.
It is based on a scientifically valid sample size (except in the case of some pilot studies).	It is more likely to be conducted on a pragmatically based sample size.
Extensive statistical analysis of data is routine. Data analysis can take a number of forms depending on whether qualitative or quantitative research has been carried out.	Some statistics may be useful.
Results can be generalisable and hence publishable. Quantitative research tends to be more easily generalisable than qualitative work.	Results are only relevant within local practice settings (although the audit process may be of interest to a wider audience and hence audits are publishable).
Responsibility to act on findings is unclear.	Responsibility to act on findings rests with individual osteopaths.
Findings influence the activities of clinical practice as a whole.	Findings influence activities of practitioners within a practice.
Always requires ethical approval.	Does not require ethical approval.
Research can identify areas for audit.	Audit can be a precursor to clinical research by pinpointing where research evidence is lacking.

What is the audit cycle?

The audit cycle is the process that is undertaken when conducting an audit in clinical practice. Unfortunately, all too often the last stage of the process is forgotten and the audit remains incomplete.

Initial baseline data is gathered on a specific area of practice. The current standard in this area of practice can be identified and new standards can then be set. Changes can be identified and implemented to try and affect practice; the effect of those changes can be evaluated and standards can be reviewed.

The clinical audit cycle
Download this image as a PDF (64Kb)

A number of different aspects of care are suitable for audit. These are described in greater depth in the brief introduction to clinical audit available below as a PDF.

A brief introduction to clinical audit
(pdf 61Kb)

Audit handbook for practising osteopaths

An audit handbook specifically intended for osteopaths in private practice has been developed by NCOR. The handbook is available to all osteopaths via the O-zone within the GOsC website. Information containing the contents of the handbook can be found here (pdf 46.3Kb).

return to top

Request changes and report errors here
Site by