Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology

Table 1 Factors to consider in the decision on a topic for a clinical audit

For the choice of an appropriate theme for a clinical audit, assess that:

The problem to be audited has an important impact in terms of costs, resources, or risk

There is some strong scientific evidence available (guidelines, systematic reviews)

The improvements made on the subject in question can be easily evaluated and source of important clinical/organisational consequence.

Table 2 Facilitating factors and barriers for effective clinical audit

Facilitating factors	Obstacles
Clarity of design and data collection	Not clear objectives and planning
Good planning	Lack of resources-heavy workload
Organisation support	Lack of clarity on the method
Dedicated staff	Lack of organizational support
Collective analysis of the results	Unwillingness to change

Table 3 Checklist for the planning and validation of a clinical audit

Item	Yes/ No
Promoting a clinical audit	The audit topic has been decided according to the needs of the working group.
	The objectives are clearly specified.
	Indicators, criteria and reference standards have been set according to literature, guidelines and/or the consensus among experts.
Design and planning	The audit has been organized in different stages and times, assigning specific responsibilities.
	Necessary resources have been allocated.
	The population/reference sample has been defined.
	Tools for data collection have been designed, preliminarily defining data management methods.
	The whole material has been proposed in advance to the participants.
Data collection	Those who participated in the preventive phase have been involved.
	The established phases have been met.
	Data have been correctly collected.
Data analysis Interventions	The results have been discussed with the participants to the audit and other interested parties.
	A structured strategy to implement changes has been defined.
	Written reports of the results have been made and sent to all the participants.
Checking the audit effectiveness	A check of the effectiveness of the changes introduced has been planned.
	The verification has been formally documented.