6. Clinical audit in the veterinary world
Clinical audit is a well-established and widely used quality improvement tool in human health care, and there is a huge wealth of available resources regarding audit methodology, which can readily be adapted for use in veterinary settings. However, there are some key differences we should consider when embarking on a veterinary clinical audit.
Criteria-based (or standards-based) audits are the most common type of clinical audit undertaken in human health care, where high quality clinical guidelines are the preferred source for deriving audit criteria from evidence (NICE, 2002). One thing to be very careful about in comparing the audit process in veterinary medicine to the audit process in human medicine, is that there are many fewer clinical guidelines available in veterinary medicine . Therefore, in many situations, we need to rely on developing our own evidence-based criteria (Mair, 2006) .
Another key difference in human health care is the provision of protected time allocated for doctors to undertake medical audit activities (National Health Service (NHS) White Paper Working for Patients, 1989). This may not be feasible within a busy veterinary practice setting, and therefore careful planning is required to ensure completion of a successful audit project, including particular attention to selecting the right audit team, setting clear and achievable audit objectives and methods for data collection. All these considerations are discussed more fully on the following pages.
As well as the quality of care we provide for our patients, we must also recognise the importance of animal owners as veterinary service users. In addition to patient-centred outcomes, veterinary clinical audit can be used to evaluate the care delivered from the client’s perspective, for example through assessing client satisfaction with a new treatment or procedure.