Assessing the Feasibility of Retrospective and Prospective Clinical Audit in Farm Animal Veterinary Practice

Abstract

As a quality improvement tool, clinical audit has been extensively described in the medical literature. There is scant literature on the use of clinical audit in the farm animal veterinary setting. This study describes the process and feasibility of prospective and retrospective data collection for farm animal clinical audit performed at three different farm animal practices in the United Kingdom. Retrospective clinical audit was difficult in all three practices due to barriers in establishing diagnosis and patient identity from clinical records. Prospective data collection proved feasible but depended on adequate case accrual and practitioner engagement. The decision to conduct clinical audit retrospectively or prospectively will depend on the topic to audit, the availability of data and the wishes of the team members involved. Further work is required looking at the use of clinical coding and alternatives to using practice management software to improve retrospective data availability for clinical audit.

Managing Shiga Toxin-Producing E. coli Using Statistical Process Control Charts for Routine Health and Production Monitoring in Pig Farming

“…This second observation might reflect the absence of a helpful tool in the field to monitor, revise and implement changes in process or procedures of care with iterative re-evaluation of quality improvement during time. SPC charts might represent the evolution of an older quality improvement tool such as the clinical audits, that are widely described in human medicine and sometimes applied in veterinary practices on companion animals, but scarcely reported in livestock ( 39 ). The limitation of clinical audits is that in human medicine they typically rely on comparison of current practice or outcomes to well defined and evidence-based “gold standards”.…”

“…In veterinary medicine, lack of evidence-based standards in many areas means that clinical audits may be done only to compare practice with a consensus or opinion-based standard, or may be used to create standards or values that allow individual practices to benchmark against processes or outcomes of other practices ( 40 , 41 ). Moreover, workload, duration, and complexity of case accrual and follow-up are consistently reported as a barrier to clinical audits ( 42 , 43 ), in particular when applied in veterinary medicine ( 39 ). SPC charts might solve some of the main limitations of clinical audits, as one or few basic key parameters [iceberg parameters; ( 44 )] may be selected and used to monitor the productive process of the farm during time compared to own data of the past.…”

Applying clinical audit for quality improvement in canine dystocia cases seen at a UK primary‐care emergency practice

“…Although pioneered within Japanese industry, 2 QI covers a broad umbrella of activity within healthcare and has been described as ‘the combined and unceasing efforts of everyone—to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)’ 3 . QI processes can support good clinical governance, enabling the fulfillment of professional responsibilities, and can count towards RCVS continuing professional development requirements 4–6 …”

“…3 QI processes can support good clinical governance, enabling the fulfillment of professional responsibilities, and can count towards RCVS continuing professional development requirements. [4][5][6] A QI framework featuring five key tools has been suggested for the veterinary profession. 1 Of those, clinical audit, a process in which named current activities are systematically reviewed and compared against explicit criteria, relevant changes are introduced, and the resultant impacts are measured, 7 encourages integration of relevant evidence-based veterinary medicine within clinical practice.…”