What Makes a Good Audit?

A good resident audit is: achievable in 4–6 weeks of data collection, relevant to current clinical guidelines, supported by your department, and clearly documented. Avoid massive multi-centre projects — a clean, well-presented single-site audit is more impressive than a half-finished ambitious one.

The Audit Cycle

1

Identify a Standard

Choose a national guideline, NICE guideline, college standard or local protocol to audit against. This is your benchmark.

2

Collect Data

Retrospective data from case notes, electronic systems or discharge summaries. Aim for 30–50 cases minimum for a meaningful sample.

3

Compare Against Standard

What percentage of cases met the standard? Where were the gaps? Be specific.

4

Implement Change

Propose or implement a change — a new proforma, a checklist, an education session, a poster.

5

Re-audit (Close the Loop)

A complete audit cycle (with re-audit) is significantly stronger for applications. Plan your re-audit from the start.

Audit Ideas — General Medicine / Internal Medicine

  • VTE prophylaxis prescribing on medical wards (NICE NG89 / local protocol)
  • Antibiotic prescribing for community-acquired pneumonia (CURB-65 use, duration)
  • Sepsis Six bundle compliance in acute medical units
  • Timely ECG in chest pain presentations
  • Discharge summary completion time and quality
  • Blood glucose monitoring frequency in inpatient diabetes management
  • NEWS2 observation frequency compliance on medical wards
  • Appropriate use of urinary catheterisation

Audit Ideas — Surgery

  • WHO Surgical Safety Checklist completion rates in theatres
  • Pre-operative antibiotic prophylaxis timing compliance
  • VTE prophylaxis after major surgery (NICE NG89)
  • Consent documentation quality for elective procedures
  • Post-operative pain scoring and analgesia prescribing
  • Surgical drain management and documentation
  • Fasting times pre-operatively (adherence to 2/6 rule)

Audit Ideas — Emergency Medicine

  • 4-hour (or equivalent) target compliance by triage category
  • Sepsis recognition and bundle initiation time
  • STEMI door-to-balloon time compliance
  • Analgesia administration time for fractures / acute pain
  • CT head request appropriateness (vs. NICE head injury guidelines)
  • FAST exam documentation in trauma calls

Audit Ideas — GP / Outpatient

  • Hypertension management and treatment target achievement
  • Chronic disease review frequency (diabetes, asthma, COPD)
  • Appropriate antibiotic prescribing for respiratory tract infections
  • Cancer referral (two-week wait / urgent) appropriateness
  • Medication review completeness for patients on multiple medications
  • Cervical screening / bowel cancer screening invitation follow-up

Tips for Completing Your Audit

  • Get a supervisor early. Most programmes require a named supervisor — identify one before you start collecting data.
  • Get Caldicott / ethics sign-off if your trust/hospital requires it before accessing patient records.
  • Use Excel. Simple spreadsheet with columns per data point. You do not need specialist software.
  • Present at a departmental meeting. This adds evidence of dissemination to your portfolio.
  • Document everything. Keep your data collection sheet, analysis and any correspondence — you will need these for your portfolio.