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Audit

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Over the past few weeks, I have been attempting to complete my audit. This has taken quite a lot of my time and I still have yet to complete it. So what is an audit? Audits are a cycle of quality improvement aimed to improve outcomes against specific standards. Ideally, the results of the audit are significant as it then enables positive changes to be made. After a set amount of time, the audit can then be repeated to check progress. 

Perception of audits among students (my friends) is generally negative. Audits are not just a box ticking exercise. They offer opportunities to improve practice and therefore improve patient care. This can only be a good thing. Limitations can occur when the standards you are auditing against are not perfect. For this reason, audit standards should be very clear. 

So why is this relevant? Well, pre-registration pharmacists will be aware that competency A4.8 states 'Have successfully carried out a small, planned audit assignment'. Those of you working in community pharmacy will also be aware that as part of the pharmaceutical services contractual framework, two audits are required each year. One is generally practice based, however the other is generally lead by a primary care organisation. I am assuming this role is to be taken on by the clinical commissioning groups now?

Audits are a part of clinical governance. Clinical governance incorporates a variety of concepts that help improve quality of a service. Some ideas behind clinical governance include patient and public involvement. This is quite an important concept, if patients aren't involved, how do you measure the benefits? Risk management, is another hot term. Everything carries a risk, especially with medicines. Minimising risk without making a process slow or inefficient can be very difficult. I always think of the Swiss cheese model when I think about risk, the Uni lecture just sticks in my mind. A paper on the BMJ, by Reason, J (2000) entitled Human error: models and management discusses the limitations of the Swiss cheese models. It's quite an interesting read, highlighting the importance of adaptability in 'high reliability organisations'. 

To conclude, I am far from an audit master but I think being aware of these concepts and terms is vital. Very vital, if you want to change current practice. 

 

More information on audits can be found at on the RPS website.

More information on clinical governance can be found on the PSNC website

Reason J. (2000). Human error: models and management. BMJ. 320 (7237), p768-770.

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