What stops effective clinical audit? Reports from the front line

Semi-structured interviews were conducted with 145 clinicians from a variet y of clinical backgrounds in twelve Trusts across three Scottish health boa rds. Questions examined barriers to the audit process and obstacles that im peded the implementation of changes in response to the audit findings as we ll as the need for resources to facilitate the audit activity. The most dif ficult part of the audit process was reported as data collection (32%) but almost half of respondents would have changed the way the audit was done wi th hindsight. The biggest barrier to doing the audit was perceived as lack of time (33%). Colleagues' attitudes posed the biggest obstacles to making changes as a result of the audit (26%). Few perceived the need for more res ources but preferred focused and proactive support from managers and audit support staff: Trusts need to work harder at creating cultures where clinic al audit is supported and actively encouraged.