Creating effective clinical audit in anaesthesia.

Audit or simply quality control concept has been introduced for more than 10-15 years in the UK. A brief introduction about its characters and importance will be discussed with more stress on the practical aspects of it. To achieve clinical effectiveness in Anesthesia or in ITU more than one issue should be addressed. The following are examples of issues that could be audited for a better performance: Admission selection (polices), The length of stay Management guidelines, Responsibilities, Daily assessment and plan, Discharge policies, Readmission prevention, Interhospital transfer, Bed blockers prevention. Two audit examples from theatre and ITU will be discussed in details. Theatre audit deals with causes of delays in theatre and over running lists. ITU audit addresses the time lagged between admission and first assessment by the admitting firm from the day of admission onward. Lessons to be learned from these two audits are: Address something you are not happy with, Meeting standards (what if there are no standards), Agree audit methodology in advance, A real life problem justifiably taken even for the first time, Even if no successful outcome at least people are aware or there is a trial to solve the problem. Solution may be by: protocol, identifying responsibilities, rota changes. Finally the importance of selecting what should be audited and monitoring these audits will be highlited.