Abstract
Audit is an important tool for quality improvement. The collection of data on clinical performance against evidence-based and clinically relevant standards, which are considered by clinicians to be realistic in routine practice, can usefully prompt reflective practice and the implementation of change. Evidence of participation in clinical audit is required to achieve intended learning outcomes for trainees in psychiatry and revalidation for those who are members of the Royal College of Psychiatrists. This article addresses some of the practical steps involved in conducting an audit project, and, to illustrate key points, draws on lessons learnt from a national, audit-based, quality improvement programme of lithium prescribing and monitoring conducted through the Prescribing Observatory for Mental Health.
Highlights
Trust priorities for audit are often driven by the requirement to evidence the implementation of National Institute for Health and Care Excellence (NICE) guidelines but other legitimate sources include local CQUINS (Commissioning for Quality and Innovation7), the requirements of the Care Quality Commission[8] (CQC), the National Health Service Litigation Authority[9] (NHSLA), the Mental Health Act 1983 code of practice[10] or the findings of primary research
It is a high-volume and high-risk treatment and clear standards can be derived from the NICE guideline for the management of bipolar disorder[11] and a National Patient Safety alert entitled Safer Lithium Therapy.[12]
If you were interested in the monitoring of renal function in patients treated with lithium, it would be best to ask explicitly whether a measure of estimated glomerular filtration rate or creatinine clearance were documented in the clinical records
Summary
Undertaking clinical audit, with reference to a Prescribing Observatory for Mental Health audit of lithium monitoring. The Royal College of Psychiatrists’ guidance emphasises that it is not direct involvement in data collection that is important, but rather the review of the audit evidence for the quality of care provided, and taking the lead in implementing strategies to improve quality where these are required. Such reflection on the data by clinicians is perhaps the most potent aspect of clinical audit. A brief summary of the differences has been produced by the Royal College of Psychiatrists’ Centre for Quality Improvement[6] but if there is any doubt about the status of an individual project, advice should be sought from the relevant trust’s audit and research and development departments
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
