Domain 2:

Safety and Quality: Audit

Audit: Criteria to be Measured

2. Criteria to be measured

Criteria and standards are often cited as the most confusing terms associated with audit. Both cause doctors and others the greatest difficulty in understanding and putting into practice. We like to think that if you can understand and differentiate between an audit 'criterion' and a 'standard' then you are well on your way to grasping basic audit method.

Criteria are simple, logical statements used to describe a definable and measurable item of health care, which describes quality and can be used to assess it.

Examples of audit criteria:

  1. Patients with a previous myocardial infarction should be prescribed aspirin, unless contraindicated.
  2. Patients with chronic asthma should be assessed at least every 12 months.
  3. Patients should wait no longer than 20 minutes in the surgery before consultation.
  4. GPs' medicine bags should contain a supply of in-date adrenaline.
  5. Surgeries should start within 5 minutes of their allotted time.
  6. The blood pressure of known hypertensive patients should be <140/85.

It is best to restrict the number of criteria to be measured for any given audit. Unless otherwise specified, auditing a single criterion is acceptable for appraisal purposes. Focusing on one or two criteria makes data collection much more manageable and the introduction of small changes to practice much less challenging. Overall it offers a better chance of the audit being completed successfully within a reasonable time span.

It is important that any criteria you choose to audit should be backed up with quoted evidence (e.g. from a clinical guideline or a review of the relevant literature). Occasionally, because of the type of topic chosen, suitable evidence is not always readily available and therefore cannot be cited. If this is the case then simply explain that there is a lack of suitable evidence on the subject, but also stress that there is consensual agreement amongst your colleagues on the importance to the practice of the particular topic and criteria that have been chosen.

Points to consider:

  • The criteria should be very relevant to the actual audit topic chosen.
  • Follow the style (short, simple logical statements) used in the above example for each criterion, where possible.
  • You must justify why each criterion is chosen, for example with reference to current literature, clinical guidelines or other evidence if available.

This page was last updated on: 15/05/2015