Clinical Audit Proposal Form
Type of Audit
Background/Rationale (Why is the clinical audit being done?)
- Patient centeredness
- High volume activity
- High risk activity
- High cost activity
- Policy/guideline recommendation
- Professional delvelopment
- Service improvement
- Risk management
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
Method of Data Collection
- Focus Groups
- I.T. Systems Data
- Patient Records
- Peer Review
- Telephone Survey
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.