Audit & Quality Improvement
AKT High-Yield Breakdown
Clinical audit and quality improvement (QI) are core components of clinical governance. The AKT tests the audit cycle, how to distinguish audit from research and QI, PDSA methodology, SEA, quality metrics, and the principles underpinning a positive patient safety culture in general practice.
What You'll Learn
Master the five-stage audit cycle (criteria → standards → data collection → compare → change), how PDSA cycles differ from audit, the distinction between audit and research, SEA methodology, common quality indicators in primary care, and the human factors that drive or undermine patient safety culture.
Practise Audit & Quality Improvement MCQs
From the five-stage audit cycle and PDSA methodology to significant event analysis, the Donabedian structure-process-outcome framework, and what distinguishes audit from research — tackle focused MCQs across the full Audit & QI curriculum.
The Clinical Audit Cycle
Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change.
Five Stages of the Audit Cycle
Audit cycle stages: (1) Select topic and set criteria — define what you are measuring and why; (2) Set standards — the expected level of performance (e.g. NICE guideline, 95% of patients with hypertension should have BP recorded annually); (3) Data collection — collect data on current practice; (4) Compare performance with criteria — identify the gap; (5) Implement change and re-audit (complete the cycle).
- Criteria: a systematically developed statement about an aspect of care (e.g. "all patients with type 2 diabetes should have an annual foot examination")
- Standards: the level of performance expected (e.g. "95% of patients" or "100% of patients") — derived from guidelines, evidence, or expert consensus
- Data collection: can be prospective or retrospective; sample size should be sufficient to detect meaningful gaps; random sampling preferred to avoid bias
- Implementing change: the most important — and often neglected — stage; change may involve protocol changes, education, IT system modifications, patient reminders
- Re-audit (closing the loop): repeating the data collection after change to assess improvement; without this, the audit is incomplete
- Audit vs research: audit measures current practice against a standard; it does not test a hypothesis, does not require ethics approval (as a rule), and does not generate new knowledge
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