An Introduction to Clinical Audit for Radiographers

4. Who should do audit?

Many Trusts will have a department dedicated to Clinical Audit, with experts contributing to strategic audit planning, project design, project management, data collection, data analysis and report production. In addition, many Diagnostic Imaging departments will have a named radiography clinical governance lead or clinical quality coordinator 3. For some types of audit (e.g. financial audits) it may be appropriate for an independent auditor to take the lead, as there is a low risk of bias. However the majority of audits should be delivered by practitioners working closest to the audit area, as they are best-placed to identify areas for improvement. Although there is a potential risk of bias, there is conversely a much better chance of the audit recommendations being implemented and patient care being improved. Medical consultants are required to undertake and lead on clinical audit, however in most countries radiographers are also required by their registering body (e.g. Health and Care Professions Council) to be engaged in auditing their practice6 . However clinical audits should where possible involve a wider group, including commissioners, managers, practitioners and service users. For most audits of processes, a multi-disciplinary team approach is essential.

Covid-19 Example:

Issue: Given the transmission risks to patients and staff, you want to assess whether the chest radiographs requested during the Covid-19 pandemic are making a difference to patient management

Audit team: While a radiographer could lead this process audit, it would need to be undertaken in conjunction with radiologists and referring clinicians. This could be a prospective audit (simple checklist to be completed by clinicians when receiving the radiograph / report) or a retrospective audit (of case notes and radiological reports).