Clinical Interventions and Audit
Paula Hayes, Audit Pharmacist, Alder Hey Children's Hospital
Medical audit was proposed in the Government working paper "Working for Patients" in 1989 with the aim of making audit a routine part of doctor's practice. The current approach is towards multi-professional "Clinical Audit" to ensure that audit spans all aspects of care within the hospital and community and is integrated into the system of quality assurance.
The principal aim of audit is to improve the quality of patient care but it can also be used as a means of identifying inefficiencies within a service and outcomes of an audit can form the basis of education and training of all members of the healthcare team.
There are numerous factors which may lead to an audit being conducted, these include:-
Clinical intervention monitoring has led to a number of pharmaceutical audits. The system used at Alder Hey has been a manual entry system onto the QARx database. We are currently switching to a computerised entry system using Amstrad pen-pads with the Epi-Info system. Clinical pharmacists record the type of intervention, drug and outcome. The data collected is discussed at monthly peer review sessions and is used for the provision of information to the Drug and Therapeutics Committee, updating Therapeutic Guidelines and producing the Therapeutic News Bulletin.
Alder Hey employs a clinical audit pharmacist who undertakes many of the pharmacy based audit projects. Clinical pharmacists have extensive ward based experience and are trained in all areas of drug therapy. They have access to extensive drug information resources along with contact with many other healthcare professionals during ward visits. The audits completed over the past few years at Alder Hey include the use of:-
and proposed audits for the future include use of:-
Clinical audit is a rapidly expanding area and in the future there will be moves towards interface audit and integrated care pathways.
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