Clinical audit as a quality improvement tool in emergency care [Poster walk]

Background Clinical audit is a healthcare quality improvement process based on systematic review of care, implementation of change and further monitoring over time. The aim of this study was to investigate the level of application and effectiveness of clinical audit in the particular field of healthcare emergency. Methods A systematic literature search was carried out, from 2004 to 2015, by a specific search algorithm through PubMed and CINAHL databases. Resulting studies were selected by two reviewers independently according to title, abstract and full text. Inclusion criteria were: clinical audits in emergency area at both primary and secondary care level. Audits focused on training, healthcare professionals’ perception or compliance to procedures/protocols, health economics or death analysis only were excluded from the review. From each article the followinginformation were extracted: first author and year of publication, study design, country and duration, study population, setting, main and specific objectives, indicators used and main results. Results Out of the 6164 retrieved studies 62 were finally selected, which were mainly carried out in Europe (51,61%) and Oceania (27,42%); 64,51% of audits were performed by a multidisciplinary team and 51,61% were focused on process, 33,87% on outcomes and 14,52% on both aspects; 88,71% were conducted at hospital and 11,29% at primary care level with various fields (e.g. cardiology, neuroscience) of application. Out of the 62 studies about 15% were complete audits (assessment and comparison with standard phase followed by improvement actions and monitoring over time). Conclusions Even in emergency clinical audit can be a valuable tool to assess clinical practice both in terms of process and outcome and improve healthcare quality, mainly at hospital level. Indeed in hospital medical records and data flows are available, hospital team are more cohesive than territorial ones and hospital is more organized than primary care.