Evaluation and Audit

Evaluation, data gathering and audit are an important part of any program or process. You may want to evaluate and collect data for a number of different aspects such as attendance, weight lost, patient's experience, staff's experience etc. There are a number of different ways to evaluate including written questionnaires, verbal questionnaires, focus groups etc and it is often useful to write down verbal comments from patients as you go along to be included as part of the evaluation. Data may be collected from a number of sources using different methods and analysed as appropriate. It is up to you which aspects you choose to evaluate and analyse, but picking a few rather than trying to do everything will be more manageable.

Clinical audit may be defined as:

"the systematic, critical analysis of the quality of clinical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient/client"

(DoH 1989)

The reason for auditing is to improve patient care and the aim is to compare actual performance against agreed standards of practice. The process should be ongoing and continuous. There are 3 basic areas that can be audited which are structure, process and outcome. There are many aspects within these areas, but it is best to focus on something that you feel may need improvement or is unknown.

Process of Audit

In order to audit something you need criteria and standards. An example of a criterion may be that people in a weight management program will know the benefits of increasing physical activity. You can then develop a standard from that criterion which would incorporate the criterion and the expected level of performance. So, using the example given before it may be that you decide by the end of the weight management program that 90% of people will be able to relate the benefits of increasing physical activity. When you then audit you will have a level to compare against.

When you have the results of the audit you will then need to discuss them and why you have got the results you have. So if the results are under the standards set you will want to try to identify why they are and then go onto decide on changes which will improve the results. The next stage of the audit cycle is to implement the changes decided upon and then to reflect on these changes made and whether they are having the desired effects.

Audit is supposed to be a continuous loop as the only way of finding out whether things have improved is to re-audit the standard. Some things are audited very regularly to make sure standards are being maintained, and ultimately hopefully to see an upward spiral of continuous improvement.

Follow the link below for a Tool Kit for Evidence-Based Practice produced by the Bradford Health Informatics Service. (Available only on the Intranet)

Link to Tool Kit