Evaluating the Progress of Clinical Audit

Abstract

This article reports on an evaluation of the progress of clinical audit in four health-care professions. The project had both a research and a development component. Interviews were held in six sites with practitioners and others with a stake in the outcome of audit. Findings indicated that a wide range of audit activities were in progress, that a diversity of factors could affect this progress, and that negative as well as positive impacts could ensue from participation in an audit. A model comprising four cycles (delivery of patient care, standard setting, carrying out audit, and decision-making concerning change) was developed from existing work, from fieldwork in the six sites, and from a process of evaluation, revision and further evaluation. The final version provided a framework which practitioners could use to analyse current audit activities and guide the planning of future projects. In particular, the model demonstrated ways in which the various factors that affected progress could act as a facilitator or constraint at each stage of the audit and decision-making cycles.