Why this matters for your practice
Clinical audit is the clearest way a practice can show it does quality improvement rather than just talks about it. Because it produces before-and-after numbers against a defined standard, it is exactly the kind of evidence an accreditation surveyor can see and trust. Practices that rely only on policies and meeting minutes often struggle to demonstrate measurable improvement; a completed clinical audit closes that gap in a single, self-contained piece of work.
How a clinical audit works
A clinical audit runs as a cycle:
- Choose a topic and standard. Pick a measurable aspect of care and the benchmark it should meet (for example, the proportion of patients with a given condition who have an up-to-date care record).
- Measure current performance against that standard using your own data.
- Identify the gap between current performance and the standard.
- Make a change intended to close it (a new recall, a template change, a staff process).
- Re-measure after a set period to confirm the care actually improved.
The re-measurement step is what makes it an audit rather than a one-off report. Common general-practice topics include chronic disease cycles of care, immunisation coverage, and medication reviews.
It is easy to confuse the three quality-improvement tools: a clinical audit measures against a standard and re-measures; a PDSA cycle is a small, rapid test of a single change; and a significant event analysis is a reflective review triggered by a specific event. They complement each other rather than being interchangeable.
What the assessor expects
- A defined standard or benchmark, not just a data snapshot.
- A documented change made in response to the first measurement.
- A re-measurement that shows whether the change worked.
- Team involvement, so the audit reflects the practice rather than one clinician.
- A record of the whole cycle that can be shown as quality improvement evidence.
Common mistakes
- Stopping at the first measurement and never closing the loop with a re-audit.
- No explicit standard, so there is nothing to measure improvement against.
- Choosing a topic that cannot be measured from the practice's own data.
- Treating it as identical to a PDSA or SEA, when each serves a different purpose.
- Auditing but not acting, so no change is made between measurements.
Frequently Asked Questions
What is a clinical audit in general practice?
A clinical audit is a quality improvement activity that measures an aspect of care against a defined standard, makes a change to close any gap, and then re-measures to confirm the care improved. It produces measurable before-and-after evidence.
What is the difference between a clinical audit, a PDSA cycle, and a significant event analysis?
A clinical audit measures performance against a standard and re-measures after a change. A PDSA cycle is a small, rapid test of one change. A significant event analysis is a reflective review prompted by a specific event. All three are quality improvement tools with different triggers and shapes.
Does a clinical audit count as quality improvement for RACGP accreditation?
Yes. A completed clinical audit, including the re-measurement step, is a well-recognised form of quality improvement evidence for RACGP accreditation because it demonstrates measurable improvement in care.
What are some clinical audit examples?
Common examples include auditing the proportion of patients with diabetes who have completed their cycle of care, childhood immunisation coverage, and reviews of patients on high-risk medicines. The key is a measurable topic with a clear standard.
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