Clinical Audit Design
This questionnaire is designed to capture the key information needed when setting up any clinical audit. It's purpose is to keep track of the resources, methodology, audit issues and scoring mechanisms for each audit proposed. It can be added to, each time an audit takes place providing a record.
Q1.
Title of audit
Q2.
Focus/Department/Ward/Speciality
Q3.
Principal Contact (Name and Profession)
Q4.
Contact Address
Q5.
Contact Number
Q6.
Lead for this clinical audit
Q7.
Bleep number
Q8.
Email address
Q9.
Please tick the boxes that apply to the audit you are proposing.
Medical
Public Health
Surgical
Commissioned
Community Health
Trust Issue
Mental Health
Risk
GP
Complaint
Social Services
Q10.
What is the quality of evidence on which the criteria/standards are based? Please tick the boxes that apply.
Meta analysis of random control trials (RCT)
Comparative or case studies
At least one RCT
Expert committee reports
At least one well designed controlled study - no randomisation
Respected authorities clinical experiences
At least one other type of well designed quasi-experimental study
Other
Main aim of the audit
Q11.
What do you hope to achieve?
Q12.
Do you have specific statements supported by evidence that will be used in the audit?
Yes
No
Q13.
Where did you find the evidence? Please tick the boxes that apply.
Literature search/research findings
NICE
National guidelines
NSF
Local guidelines
Professional body
Methodology
Q14.
Does your audit include the following:
Q14.1.
Target group
Q14.2.
Method of sample selection e.g. random
Q14.3.
Estimate of sample size
Q14.4.
Level of confidence/convenience sample
Q14.5.
Examination of clinical records
Q14.6.
Observation practice
Q14.7.
Questionnaire
Q14.8.
retrospective/concurrent/prospective collection
Q14.9.
Is your audit tool signed off as satisfactory?
Q15.
Please outline the resources you will need to make the audit successful?
Q15.1.
Case note retrieval
Q15.2.
X-ray retrieval
Q15.3.
Patient identification and information
Q15.4.
Advice on literature review
Q15.5.
Developing criteria & standards
Q15.6.
Action planning
Q15.7.
Advice on report writing
Q15.8.
Presentation support
Q15.9.
Management of change
Q16.
Other Clinical audit issues:
Discussed
Relevant
Q16.1.
Funding for the audit process
Q16.2.
Confidentiality
Q16.3.
Access to data
Q16.4.
Agreed disclosure of audit results - internal
Q16.5.
Disclosure of audit results - external
Q16.6.
Patient involvement in planning the audit process
Q16.7.
Patient participation in the audit process e.g. patient questionnaire
Q16.8.
Approval for dealing with sensitive issues
Q16.9.
Re-audit