iAuditor Mobile App Preview

Clinical Audit Proposal Form

Project Title

Type of Audit

Background/Rationale (Why is the clinical audit being done?)

Additional Reasons (Select all that apply)

Aims/Objectives (How will the clinical audit improve patient care?)

Have all the potential stakeholders been identified?

Are these stakeholders aware of this audit?

Will patients/service users be involved?

How? What are your inclusion criteria?

Estimated Sample Size

What standards will you be auditing against?

Type of Data Collection

Specify

Method of Data Collection

Specify

Data Source (Select all that apply)

Specify

Anticipated Audit Dates

I confirm that the information provided on this form is accurate to the best of my knowledge. By signing this form I agree to ensure that this project will be completed, the results disseminated and a report and action plan will be given to both the Quality & Governance Team and Division.

Audit Lead Name & Signature
Senior Supervisor Name & Signature

Clinical Audit Proposal Form

Created by: SafetyCulture Staff | Industry: General | Downloads: 2

A clinical audit proposal form specifies the background/rationale, aims/objectives, sample inclusion criteria, standard statement, and method of data collection prior to a local or national government-initiated clinical audit. Identify potential stakeholders and patients or service users to be involved and specify anticipated audit dates with the use of this clinical audit proposal form. Before submission, the audit lead and the audit sponsor, usually a senior supervisor, can digitally affix their signatures in this clinical audit proposal form.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

Browse for other checklists


iauditor logo

The World's #1 Cloud-Based Inspection Software and App

chevron logo
coles logo
emirates logo
overground logo
tesla logo
toyota logo

Clinical Audit Proposal Form

Project Title

Type of Audit

Background/Rationale (Why is the clinical audit being done?)

Additional Reasons (Select all that apply)

Aims/Objectives (How will the clinical audit improve patient care?)

Have all the potential stakeholders been identified?

Are these stakeholders aware of this audit?

Will patients/service users be involved?

How? What are your inclusion criteria?

Estimated Sample Size

What standards will you be auditing against?

Type of Data Collection

Specify

Method of Data Collection

Specify

Data Source (Select all that apply)

Specify

Anticipated Audit Dates

I confirm that the information provided on this form is accurate to the best of my knowledge. By signing this form I agree to ensure that this project will be completed, the results disseminated and a report and action plan will be given to both the Quality & Governance Team and Division.

Audit Lead Name & Signature
Senior Supervisor Name & Signature