From the Guidelines
Clinical audits play a crucial role in Laboratory Medicine (LM) by driving improvements in health outcomes through the systematic review and feedback of clinical performance. The use of computerized audit and feedback systems in healthcare, including LM, has been shown to be effective in improving care quality and health outcomes 1. These systems, often delivered as “dashboards,” incorporate visualization elements to deliver feedback of clinical performance, offering potential advantages over manual audit and feedback methods through lower costs and quicker feedback 1. Key aspects of clinical audits in LM include:
- Selecting an audit topic, setting standards, collecting data, analyzing results, implementing changes, and re-auditing to assess improvement
- Focusing on pre-analytical errors, analytical performance, post-analytical processes, turnaround times, and utilization of laboratory resources
- Requiring clear objectives, appropriate methodology, adequate resources, and staff engagement
- Being conducted regularly as part of continuous quality improvement programs The benefits of clinical audits in LM include:
- Enhanced patient safety
- Improved laboratory efficiency
- Reduced errors
- Better compliance with regulations
- Optimization of resource utilization As highlighted in a recent systematic review and narrative synthesis of computerized audit and feedback systems in healthcare, the optimization of intervention design is required to reduce variability in outcomes, and contextual factors such as data infrastructure and existing ways of working need to be considered 1. Therefore, laboratory directors should establish a structured audit program with dedicated personnel and integrate findings into the laboratory's quality management system to ensure sustained improvements in laboratory medicine practices.
From the Research
Role of Clinical Audits in Laboratory Medicine
- Clinical audits in laboratory medicine are defined as a process of review and assessment of laboratory performance, aiming to improve patient care by enhancing laboratory performance and making better use of resources 2.
- The primary goal of clinical audits in the laboratory is to provide feedback to the users of the laboratory and its staff, measuring performance against established standards, ideally based on evidence-based medicine 3.
- Areas of audit in the laboratory include the preanalytical, analytical, and postanalytical phases, with the assessment of the contribution of the clinical laboratory to patient outcome being a further extension of clinical audit in laboratory medicine 4.
Implementation and Effectiveness
- Clinical audits are part of the continuous quality improvement process and a key element of clinical governance, involving the implementation of changes and re-audit to ensure maintenance of these changes 3.
- The practice of clinical audit and the application of evidence-based medicine are seen as powerful educational tools, with randomized clinical trials forming the basis for assessing the value and contribution of the laboratory to the outcome 4.
- A multifaceted and individualized implementation strategy, including participation in clinical audits, has greater potential for success in closing the gap between evidence and practice in laboratory medicine 5.
Impact on Quality and Safety
- Clinical audits are essential for maintaining and improving quality and safety in healthcare services, particularly in developing nations, with multiple clinical audits providing a comprehensive understanding of clinical practice and encouraging systemic improvements 6.
- The findings of studies suggest that clinical audits can lead to significant improvements in adherence to guidelines and better clinical outcomes, demonstrating the efficacy of clinical audits in improving clinical practice and outcomes 6.