Why audit?

All of us who work in the perioperative arena, from clinical practitioners to managers and educators, endeavour to provide safe and effective care for patients. We all want to deliver high quality care and to be sure we are meeting the recognised standards and guidelines, but how do we know we are achieving that goal? There is so much information available and the goal posts are changing all the time. Feedback from patients and service users is a helpful indicator, however this can be very subjective.

So, step forward the ‘A’ word … audit! ‘Audit in healthcare is a process used by health professionals to assess, evaluate and improve care of patients in a systematic way. Audit measures current practice against a defined (desired) standard’ (Benjamin 2008).

Now the very mention of audit can instil a range of reactions, from excitement and expectation to fear and weariness. It all depends upon your experiences of audit. However, this shouldn’t have a negative or intimidating association. It is not the intention to find fault, apportion blame or lead to confrontation. The purpose is to compare practices with the desired standards and to promote best practice. Audit presents the opportunity to ask if activities are being done correctly, not to be confused with research, which asks what should be done. ‘Research is concerned with discovering the right thing to do; audit with ensuring that it is done right’ (Smith 1992).

Audit is not a new concept. Florence Nightingale conducted one of the first clinical audits. She is famous for improving sanitary conditions in hospitals during the Crimean War and thereby improving infection rates. What is less well known is that she also kept thorough records, which demonstrated that her practices were producing a fall in mortality rates.

She certainly saw the benefits of audit and that is the approach we should emulate. Adopt a positive perspective and engage in audit to reap the benefits such as improvements in care and patient outcomes, education opportunities and promoting effective teamwork.

A team approach is essential. Clinical audit needs to be supported by managers who can authorise changes. They also need to commit to the process. There is no doubt that audit can be time consuming and this needs to be factored into work plans. Similarly, staff need training and development to ensure they feel confident and enabled to participate in the process.

AfPP have been leaders in promoting clinical audits in the perioperative environment through our multi-professional audit tool. ‘The Perioperative Audit Tool’ supports peer assessment and the sharing of good practices. Consultants can offer advice and expertise to support the process, one of the greatest aspects of this document is that it is owned by the clinical team. Practitioners look at their own practices and compare them to the standards depicted. They then develop, implement and evaluate action plans to address areas of concern. Everyone is involved in promoting a collegiate response. The result is improved patient care, increased staff satisfaction and effective teamwork.

I have conducted several audits and can attest to the benefits. Furthermore, the feedback from the staff involved has been positive. I have used the AfPP audit tool and I am delighted to announce the latest edition is now available. I urge you to bite the bullet, overcome your fear or dislike of audit, and engage in something that you can own and that can really make a difference to care delivery.To order a copy of the latest edition of the Perioperative Audit Tool email: orders@afpp.org.uk