The Audit Cycle

1
The Audit Cycle
Choose the Topic
Define Criteria Standards or What do you think
you should be doing
Define Criteria Standards or What do you think
you should be doing NEXT
Collect the Data i.e. The Information on what
you are doing
Identify the Changes Required Implement Them
!!
Assess Performance against criteria
standards How are we doing in relation to what
we should be doing ?
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The Audit Cycle

• Choosing The Topic
• Aspirin Prescribing in Post MI Patients

3
The Audit Cycle

• Define Criteria Standards
• Criteria - what you want to measure (yard-stick)
• Patients with a previous MI should be taking
  aspirin, unless contraindicated.
• Standard - how well you should be doing
• 90 of patients with a previous MI should be
  taking aspirin, unless contraindicated.

4
The Audit Cycle

• Collect the Data
• 1. Identify patient group (i.e. those with a
  previous MI)
• e.g. Computer Search, Repeat Prescribing
• 2. Check their Aspirin Status

5
The Audit Cycle

• Assess Performance
• Compare our results with the
• standard previously set
• e.g. Find that out of 125 patients with a
• previous MI, 72 are on aspirin

6
The Audit Cycle

• Agree Implement
• Changes Required
• 1. Feed the results back to colleagues
• 2. Discuss ways to improve situation, agree on a
  solution and implement it.
• Short-term Recall patients to initiate aspirin
  rx
• Long-term system issue

7
The Audit Cycle

• Repeat the Audit!!!
• Data Collection 2
• Review aspirin status in those patients with a
  previous MI

8
The Audit Cycle

• Re-assess Performance
• Compare the results with the
• standards previously set and results
• of data collection 1
• Has the standard now been met?
• e.g. Now find that 94 of eligible patients are
  now
• on aspirin

9
The Audit Cycle

• Identify Further Changes Required
• Long term issues
• Determine if further change is required to
  sustain
• performance and decide when next to review.

10
Criteria - Defined

• Criteria - what you want to measure (yard-stick)
• Describe a definable and measurable item of
  health care which describes quality, and which
  can be used to assess it
• e.g. Patients with chronic asthma should have
  their inhaler technique assessed at least once
  every 12 months.

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Standard - Defined

• Standard - how well you should be doing
• Describes the measurable level of care to be
  achieved for any single criterion
• e.g. 80 of patients with chronic asthma should
  have their inhaler technique assessed at least
  once every 12 months.

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Examples of Criteria Standards
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Choosing Topics for Audit!

• When reviewing topics for audit, we can ask 3
  questions
• What facilities are there? gtSTRUCTURE
• What was done to the patient? gtPROCESS
• What was the result for the patient? gtOUTCOME

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Examples of Topics for AuditSTRUCTURE What
facilities are there?
15
Examples of Topics for AuditPROCESS What was
done to the patient?
16
Examples of Topics for AuditOUTCOME What was
the result for the patient?
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Examples

• Structural audit criterion Patients record
  cards should contain a summary card.
• Process audit criterion The blood pressure of
  patients aged 20-65 years should be taken and
  recorded at least every 5 years.
• Outcome audit criterion Patients with
  established hypertension aged 20-35 years will
  have a diastolic level less than 90 mmHg within
  the 1st year of treatment