"Clinical audit is a vital part of ensuring our services are the best they can be"

All health and care organisations take part in clinical audits. While they are primarily a way to find out if health services are meeting local and national standards and targets, they’re also a brilliant opportunity to get involved in improving the quality of care and treatment we provide.

At South West London and St George’s, we have a clinical effectiveness team who support services to set up and run their own clinical audits. We caught up with Shade Adedipe, the team’s Senior Clinical Effectiveness Co-Ordinator, to find out more about clinical audits and the work of the team.

Q. What is a clinical audit?

First and foremost, clinical audits are designed to find out whether the quality of a service meets defined standards of best clinical practice, which may be derived from national guidance (e.g. NICE), or from a service evaluation and/or research. Audits provide the evidence to show when we’re getting it right and where the focus of improvement activity should be.

However, taking part in audits is much more than doing a simple evaluation and checking whether we’ve met certain standards. They offer a real opportunity for us to make a difference and drive the changes we want to see in our services. And the process doesn’t stop once an audit has been completed. It’s important that we use our findings to agree and implement actions and share learning with colleagues across the Trust.

Q. What does the clinical effectiveness team do?

The Trust sets an annual programme of clinical audits, both national and local. Each service identifies which audits and evaluations are a priority and manages these programmes with the support of our team. We help services by offering the advice, support and resources needed to successfully complete clinical audits.

Q. What is the difference between clinical audits, clinical effectiveness and quality improvement?

Clinical audit is a tool we use to review and evaluate our services, while clinical effectiveness is about monitoring and improving the outcomes of our patients and service users.

Quality improvement (QI) is about being innovative in our thinking and testing out new ways of doing things. The starting point is to identify a problem or a place where you would like to see improvement, and this becomes a QI project. So clinical audits are a great way of identifying potential QI projects.

Q. How many clinical audits does the Trust complete each year?

We’ve seen an increase in clinical audit activity over the last year which is fantastic! In 2021, our services completed and logged a total of 271 clinical audits.

Successful clinical audits that have been completed include:

• An audit of the quality and relevance of risk assessments and care plans. The findings showed 92% of risk assessments had been completed in a timely fashion, and around half were of high or very high quality. This led to an action plan from the community service line to improve the quality and timeliness of those that remain, including additional training for many staff. The audit will repeated next year to track improvements.
• An audit into service users having falls on wards, which was carried out by the physical health team. This identified a number of areas for potential improvement, particularly in the older adults wards where the vast majority of the falls occurred. The process for assessing the risk of falls in vulnerable adults has been simplified and streamlined, and additional resources to reduce the risk of falls have been made available to teams. The audit will be repeated in 2023 to monitor the impact of these changes to practice.

Q. What is your message for staff as we celebrate Clinical Audit Awareness Week?

Clinical audit is a vital part of ensuring our services are the best they can be to meet the needs of our communities. We would really encourage anyone interested in getting involved in our clinical audit work to get in touch with us via clinicalaudit@swlstg.nhs.uk.

Finally, we want to thank everyone who has taken part in or contributed to the Trust’s clinical audit programme over the past year – your work will make a difference!