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A turning point in modern medicine: Why is clinical audit so important in the NHS?
In the UK National Health Service (NHS), clinical audit is seen as a key process for improving patient care and outcomes. This systematic quality improvement process is designed to review patient care using clear standards and implement appropriate changes. This is not just a procedure, but also an important mechanism reflecting the progress and supervision of the medical system.
The core of clinical audit is to check whether medical services are performed according to the expected standards and promote improvement accordingly.
The history of clinical audit dates back to the ninth century, when Abbasid Caliph Al-Muqtadi required medical audits to examine clinics and authorize physicians because of medical errors that led to patient deaths. Meanwhile, medical auditing in modern history has more iconic figures, such as Helsa Nightingale and Ernest Goldman, whose efforts laid the foundation for contemporary medical quality management.
Nightingale's sanitary measures during the Crimean War reduced the mortality rate from 40% to 2%.
Although early successes laid the foundation for clinical audit, the process continued to develop slowly over the next 100 years, with varying levels of awareness and acceptance among healthcare professionals. As medical treatment evolves, the definition of clinical audit is also changing, gradually transitioning from a physician-centered to a patient-centered approach. This change shows the importance of integrated medical services and interdisciplinary collaboration.
The purpose of clinical audit is to continually assess and improve the quality of patient care.
In 1989, the UK's white paper Working for Patients first incorporated clinical audit into the professional health care system. This marks the official establishment of clinical audit as part of NHS quality assurance and medical management. Subsequent policies such as The New NHS: Modern and Reliable further consolidated the place of the review process in clinical governance.
The clinical audit process consists of multiple stages, starting with identifying the problem or issue, setting standards and criteria, collecting and analyzing data, and finally deriving improvement plans and implementing changes. Each cycle aims to reach higher quality standards.
Clinical audit is an ongoing process designed to continually improve the quality of care.
Reflecting on past auditing experiences, clinical audit is not only an assessment of past performance, but also a tool to change future medical treatment methods. This systematic evaluation allows health care workers to reflect on their own practice and quickly change strategies when necessary.
In the NHS, clinical audit is embedded in clinical governance, a framework that provides a standardised process for service improvement and drives collaboration between teams. In addition to the UK, other countries are gradually introducing clinical audits in a similar context. For example, hospitals in Hong Kong and Malta have also been affected by this policy, which has promoted the improvement of medical quality.
The promotion of clinical audit is to improve the quality of medical services, which is the direction of common efforts of all medical institutions.
While clinical audits can lead to significant improvements, hospitals and clinical staff sometimes face challenges in responding to their recommendations. This requires ongoing efforts by healthcare authorities to inspire healthcare teams to take audits seriously and ensure they are implemented effectively.
Clinical audit enables the healthcare system to continuously learn and improve, making higher standards of patient care possible. In the future, how should we ensure that this systematic process can continue to promote the improvement of medical quality?
