Auditting

Question 1

What is the purpose of audit?

Answer 1

To review processes, procedures and/or outcomes to see how accurate and effective they are at conforming to a set of standard, followed by implementing changes and re-auditing.

Question 2

What is the aims of audit?

Answer 2

• Demonstrate quality of service
• Identify areas of change
• Improve quality
• Assist with the implementation of policies and guidelines
• Monitor consistency of performance
• Measure actual performance against the benchmark
• Compliance with ISO 15189

Question 3

What is an internal and external audit?

Answer 3

Internal audit is carried out by the laboratory to assess its own processes and conform with ISO and Clinical Governance framework

External audit is carried out by appropriate outside bodies. i.e. UKAS, HSE, EQA

Question 4

What is a clinical audit?

Answer 4

A clinical audit is a quality improvement process which seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria.

Clinical audit is part of clinical governance and can:
• Provide evidence of current practice against national guidelines or NHS standards.
• Provide information about the structures and processes of a healthcare service and patient outcomes.
• Assess how closely local practice resembles recommended practice.
• Check “Are we actually doing what we think we are doing?”
• Provide evidence about the quality of care in a service to establish confidence amongst all of its stakeholders – staff, patients, carers, managers and the public.

Question 5

What is the difference between a prospective audit and a retrospective audit?

Answer 5

Prospective audit involved the collection of real time data and a retrospective audit is a historical review of data.

Question 6

What is a vertical audit?

Answer 6

A vertical audit examines more than one part of a process on one item

Purpose: A detailed check of all elements associated with a chosen sample. Involves selecting a sample at random and following the sample through the laboratory from booking in to the issuing of a report. All activity which is contributes to the final report is audited (e.g. staff training, equipment logs, dates on reagents..). Looks at conformance with quality assurance procedures and SOPs.

Advantages: Cuts across interfaces within the system and shows how the process operates as a whole. Helps determine the effectiveness of the system.

Question 7

What is a horizontal audit?

Answer 7

A horizontal audit examines one part of a process applied to more than one item - one element of the quality system is assessed.

Purpose - Check in detail a particular aspect of the documentation and implementation of the quality management or test process. Can take the form of a specific question (e.g. are all staff training records up to date, is all equipment calibrated, does every member of staff have a job description?)

Question 8

What is an examination audit?

Answer 8

An examination audit is witnessing an examination or procedure as it is carried out.

Purpose:

• Observe whether an SOP is being followed and the member of staff is able to work competently and safely.
• Check that 1) SOPs are correct and 2) the person performing the task is trained to carry out the task competently
• Opportunity to talk to staff to ascertain if they are happy with training and have correct level of supervision.