What Stops Effective Clinical Audit? Reports from the Front Line

Abstract

Semi-structured interview were conducted with 145 clinicians from a variety of clinical backgrounds in twelve Trusts across three Scottish health boards. Questions examined barriers to the audit process and obstacles that impeded the implementation of changes in response to the audit findings as well as the need for resources to facilitate the audit activity. The most difficult part of the audit process was reported as data collection (32%) but almost half of respondents would have changed the way the audit was done with hindsight. The biggest barrier to doing the audit was perceived as lack of time (33%). Colleagues' attitudes posed the biggest obstacles to making changes as a result of the audit (26%). Few perceived the need for more resources but preferred focused and proactive support from managers and audit support staff. Trusts need to work harder at creating cultures where clinical audit is supported and actively encouraged.

Achievements and lessons learnt from facility‐based maternal death reviews in Cameroon

“…This represents a real challenge in itself. Obstacles to implementing MDRs or clinical audit are well known . In Cameroon, assuming the training will be adequate, two main obstacles remain: the lack of local resources to correct the problems identified through MDRs and the perceived lack of potential benefit for the healthcare providers in implementing MDRs (increased workload, relationship problems).…”

Guidelines and tools for organizing and conducting maternal death reviews

“…The biggest obstacle to making changes resulting from MDR and near-miss case reviews is colleagues' attitude and lack of support from facility managers [10][11][12]. Health professionals have to be aware of these obstacles but should also be encouraged by the successful experiences documented in Malawi [13] and Senegal [8,14].…”

Clinical effectiveness: a structured teaching approach for junior doctors

“…Previous studies have demonstrated that clinical audit projects often fail to complete the loop and become a waste of resources (Gnanalingham et al, 2001). Furthermore, other studies demonstrate that there are significant barriers to the clinical effectiveness process (Johnston et al, 2000). One such barrier may be the constant movement of junior doctors as they embark on rotational training.…”