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

Background\r\nClinical audit is a healthcare quality improvement process\r\nbased on systematic review of care, implementation of change\r\nand further monitoring over time. The aim of this study was to\r\ninvestigate the level of application and effectiveness of clinical\r\naudit in the particular field of healthcare emergency.\r\nMethods\r\nA systematic literature search was carried out, from 2004 to\r\n2015, by a specific search algorithm through PubMed and\r\nCINAHL databases. Resulting studies were selected by two\r\nreviewers independently according to title, abstract and full\r\ntext. Inclusion criteria were: clinical audits in emergency area\r\nat both primary and secondary care level. Audits focused on\r\ntraining, healthcare professionals’ perception or compliance to\r\nprocedures/protocols, health economics or death analysis only\r\nwere excluded from the review. From each article the followinginformation were extracted: first author and year of publication,\r\nstudy design, country and duration, study population,\r\nsetting, main and specific objectives, indicators used and main\r\nresults.\r\nResults\r\nOut of the 6164 retrieved studies 62 were finally selected,\r\nwhich were mainly carried out in Europe (51,61%) and\r\nOceania (27,42%); 64,51% of audits were performed by a\r\nmultidisciplinary team and 51,61% were focused on process,\r\n33,87% on outcomes and 14,52% on both aspects; 88,71%\r\nwere conducted at hospital and 11,29% at primary care level\r\nwith various fields (e.g. cardiology, neuroscience) of application.\r\nOut of the 62 studies about 15% were complete audits\r\n(assessment and comparison with standard phase followed by\r\nimprovement actions and monitoring over time).\r\nConclusions\r\nEven in emergency clinical audit can be a valuable tool to\r\nassess clinical practice both in terms of process and outcome\r\nand improve healthcare quality, mainly at hospital level.\r\nIndeed in hospital medical records and data flows are available,\r\nhospital team are more cohesive than territorial ones and\r\nhospital is more organized than primary care.