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The Importance of Clinical Effectiveness and Clinical Audit

Clinical effectiveness: ensuring that care given is based on sound evidence, such as that produced by reliable research. Clinical effectiveness is made up of a range of quality improvement activities and initiatives including:

  • Evidence, guidelines and standards to identify and implement best practice
  • Quality improvement tools, such as clinical audit, to review and improve treatments and services
  • Assessment of evidence as to whether services/treatments are cost effective
  • Development and use of systems and structures that promote learning and enable learning across the organisation
  • Information systems to assess current practice and provide evidence of improvement


Clinical audit can assist in identifying where decisions should be made to make changes in practice to improve clinical effectiveness. It is essential to have feedback to confirm that the agreed changes are being implemented every day, for every patient for whom the practice applies; this is where clinical audit supports the implementation of clinically effective practice.


Clinical Audit

Clinical Audit can be defined as a systematic review of clinical care given by healthcare professionals. Practice is measured against explicitly agreed standards and for clinical practice to be continually effective, changes or modifications in practice are made where indicated to improve patient care. It is recognised that action is often not solely required from the participating clinicians, often organisational change is needed as well.

The Department of Health in various published documents identifies an expectation that all healthcare professionals including nurses, doctors, therapists and other members of the healthcare team take part in clinical audit.

There are close links between clinical risk management, clinical effectiveness and audit and quality, which are all components of clinical governance. The Trust is committed to supporting and facilitating the implementation of recommendations arising from clinical audit, in order to improve the quality of patient care.

Audit does not need to be difficult, keep it simple.

There is a misconception that clinical audit has to be complex. The most effective audits are simple, quick and address a quality issue central to healthcare provision. For this to be the case an emphasis must be placed on the selection of an appropriate audit topic and the design of the audit

Clinical Audit should be positive and highlight both good practice and clinical effectiveness.


Clinical Guidelines

Clinical guidelines aim to help health professionals and patients make the best decisions about treatment or care for a particular condition or situation. The authors of guidelines review the research literature and take advice from experts to gather the current evidence on which to base the recommendations in a guideline. Doctors, nurses and other health care professionals are encouraged to follow clinical guidelines where appropriate.

The main organisations in the UK involved in writing and publishing guidelines include:

  • NICE - National Institute for Health and Clinical Excellence
  • SIGN - Scottish Intercollegiate Guidelines Network
  • NCGC - National Clinical Guideline Centre
  • GAIN - Guidelines and Audit Implementation Network
  • CKS - Clinical Knowledge Summaries
  • Professional Organisations and Royal Colleges
  • NICE Evidence Services


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