An Introduction to Clinical Audit for Radiographers

10. Audit timelines and feedback loops

When undertaking a more complex process audit, several indicators may be required. A review of a patient pathway may require a range of data to be collected 'in situ' and analysed rapidly to facilitate an on-going feedback loop. Trends over time are also important, and some aspects, such as radiation doses, may need to be reviewed retrospectively 16. This more detailed analysis may provide longer term recommendations for the management of patients.

Covid-19 Example:

Issue: A radiology manager wishes to measure the effectiveness of the chest imaging service during the pandemic, so that he/she may learn lessons for any future outbreaks.

In situ feedback loops - Several criteria and indicators may be assessed either continuously or at certain points in time (e.g. weekly) during the pandemic. Concurrent 'in situ' data collection may include imaging activity data, staff availability, referral to test times, test to report times, reject rates, compliance with justification, safety etc. Information is captured and analysed immediately to enable rapid resource management and process issues to be addressed.

Longer term outputs - Some aspects are better suited to retrospective audit after the pandemic, or perhaps after a first wave has concluded. Data collection may be via case note review or activity and reporting database review. Examples include the impact of chest radiographs on patient management; accuracy of chest radiographs compared to CT; staff dose monitoring review. These may give longer term recommendations for the management of patients in future epidemics, such as the need for, or timing of, chest x-rays.