Clinical Audit in Diagnostic Radiology

Introduction

For a variety of reasons - professional, public, financial and political - most countries seek to establish visible systems for managing quality in heath care. One of the key elements in this development is the establishment of clinical audit. Clinical audit involves evaluation of data, documents, and resources to check performance against standards. It is essentially a process of fact finding and interpretation and, as such, provides an efficient tool for quality improvement. The purpose of a multidisciplinary clinical audit can be generally summarized as:

To improve the quality of patient care
To promote the effective use of resources
To enhance the provision and organization of clinical services
To further professional education and training

Comprehensive Clinical Audits of Diagnostic Radiology Practices: A Tool for Quality Improvement
(Human Health Series No. 4, STI/PUB/1425); 2010, International Atomic Energy Agency, Vienna, Austria.

Auditorías clínicas completas de prácticas de radiología diagnóstica: Un instrumento para mejorar la calidad (Auditoría de garantía de calidad para la mejora y el aprendizaje de la radiología diagnóstica (QUADDRIL))
(Human Health Series No. 4, STI/PUB/1425); 2011, International Atomic Energy Agency, Vienna, Austria.

Important Principles

Multidisciplinary clinical audit concerns not only the clinical practice within individual professions but also demonstrates the contributions made by each and the organizational links between them. Clinical audit thus reflects the clinical directorate and health care team setting as well as their relationship to the overall management structure.

By comparing the practice of the service against the standards of good practice, clinical audits can inform the staff of the health care service as well as all other stakeholders about the essential elements of quality and the weak points of the overall clinical service. The audits will indicate the areas for improvement and give reassurance on issues such as safety and efficacy, all of which are essential to creating an environment of continuous development.

Confidentiality is a critical issue in relation to the clinical audit. It is essential that all parties, those being audited and those carrying out the audit; respect the confidentiality of patient data, the interviews/discussions with staff and the audit check sheet/performance data. Confidentiality will facilitate the discussion of important quality assurance issues.

External clinical audits in diagnostic radiology bear a close relationship with other quality assessment systems, such as certification of quality systems and accreditations, and also regulatory inspections for radiation protection and safety. However, it is of high importance to understand that clinical audit is different from these other quality assessment systems. The focus in clinical audits is, as a peer review activity, always on the clinical issues of the service, where comparisons with clinical good practice are relevant, and the results are recommendations with no inherent obligation on their implementation.

Available resources and additional references (see related files and links).

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