Anderson Peter, Fee Peter, Shulman Rob, Bellingan Geoffrey, Howell David
Royal Sussex County Hospital, Brighton, UK.
Br J Hosp Med (Lond). 2012 Sep;73(9):526-9. doi: 10.12968/hmed.2012.73.9.526.
A comprehensive review of the clinical audit programme in a teaching hospital intensive care unit.
A retrospective analysis of the clinical audit projects undertaken within the intensive care unit over the preceding 2 years and compared with published national guidelines for clinical audit.
A 27-bedded teaching hospital intensive care unit in the UK.
Each audit project was reviewed independently by two assessors. The following questions were assessed. 1. Were the projects true audits? 2. Were they prospective of retrospective? 3. Did the projects have input from appropriate members of the multidisciplinary team. 4. How many of the audit projects were re-audits? 5. Of the re-audits how many showed evidence of service improvement? each audit project was also scored against the Audit Project Assessment Tool produced by the UK Clinical Governance Support Team.
Of the twenty five audit projects reviewed twenty two were considered to be true audits. All of the projects used only retrospective data. Audit projects were contributed from all sections of the multidisciplinary critical care team but there were few truly multidisciplinary projects. Four of the audit projects were re-audits, of these three showed service improvement and one showed deterioration. Of the twenty two true audit projects reviewed, eleven were classified as good quality projects using the Audit Project Assessment Tool.
Despite the clinical audit programme being active and well supported, objective evidence of clinical governance benefit was lacking. The overall clinical audit programme has been revitalised by a series of improvements since undertaking this review and this approach is recommended to other organizations who are interested in improving their clinical audit performance.
对一家教学医院重症监护病房的临床审计项目进行全面回顾。
对重症监护病房在过去2年中开展的临床审计项目进行回顾性分析，并与已发布的国家临床审计指南进行比较。
英国一家拥有27张床位的教学医院重症监护病房。
每个审计项目由两名评估人员独立审查。评估以下问题。1. 这些项目是真正的审计吗？2. 它们是前瞻性的还是回顾性的？3. 这些项目是否有多学科团队的适当成员参与？4. 有多少审计项目是重新审计？5. 在重新审计中，有多少显示出服务改进的证据？每个审计项目还根据英国临床治理支持团队制作的审计项目评估工具进行评分。
在审查的25个审计项目中，22个被认为是真正的审计。所有项目仅使用回顾性数据。审计项目来自多学科重症监护团队的各个部门，但真正的多学科项目很少。4个审计项目是重新审计，其中3个显示服务改进，1个显示恶化。在审查的22个真正的审计项目中，11个使用审计项目评估工具被归类为高质量项目。
尽管临床审计项目积极开展且得到了充分支持，但缺乏临床治理效益的客观证据。自进行此次审查以来，通过一系列改进措施，整体临床审计项目得到了振兴，建议对改善其临床审计绩效感兴趣的其他组织采用这种方法。
