Clinical audit is a tool designed to improve the quality of patient care, experience and outcome through formal review of systems, pathways and outcome of care against defined standards, and the implementation of change based on the results.
As part of clinical governance, healthcare organisations are accountable for continually improving the quality of their services. Clinical audit, correctly and professionally conducted, is a powerful tool to improve patient care, experience and outcome.
Methodology: the audit cycle
Audit uses specific methodology in which performance is compared with a preselected standard. If the standard is not achieved, reasons for this are explored, change is implemented and a re-audit is carried out to ensure improvement. This methodology is often described in terms of the audit cycle.
ESR clinical audit initiative
The ESR cooperates with institutions including the European Commission and HERCA to ensure that clinical audit is applied properly to improve quality of patient care in Europe, but also to understand the regulators' perspective for its efforts regarding audit.
The ESR Audit and Standards Subcommittee has produced 26 Level I Audit Templates based on patient safety issues. As a next step, the Audit and Standards Subcommittee is working on a package of audit tailored to the Euratom legislation, and then proceeds to other aspects of system-wide audit.
In the context of the implementation of the Basic Safety Standards Directive, the ESR works with stakeholders to increase awareness of clinical audit among radiologists, which is limited compared to other aspects of the BSS directive such as justification and optimisation, and to provide radiology departments with a toolkit to perform audits effectively.
Clinical audit for medical radiological procedures is a requirement in the Euratom Basic Safety Standards Directive, and has been a part of the previous Euratom Directive (97/43). According to the directive, clinical audit must be carried out according to national procedures. This has led to significant variation between EU member states. The European Commission publishes guidance on clinical audit to harmonise the approaches among member states.