Clinical Audit - Example Audits

• Medical History
• Basic Life Support
• Oral Cancer Screening
• Patient Notes

Radiograph Audits

1. Set a standard you feel is reasonable and practical. For example - 85% of intra-oral radiographs will be clinically acceptable
   
   
2. Define what you mean by clinically acceptable. For example:
   A bitewing radiograph is clinically acceptable if it meets 10 of the following 12 criteria:
   • Mesial 8 to distal 4 visible
   • Cusps superimposed
   • No proximal overlap
   • 3mm of crestal bone visible
   • No uneven distortion
   • No coning-off
   • Good contrast
   • Correct exposure
   • No bend or fold marks
   • No processing artefacts
   • No chemical staining
   • Correctly labelled, dated, and stored
   • Can you think of more?
     
     
3. Draw up a similar list for periapicals, occlusals, or OPGs, if they are being included in your study. Use a separate list for each.
   
   
4. Create data collection sheets to score your films, with a column for each criterion

   Film No	8 to 4 visible	Cusps superimposed	No proximal overlap	etc	etc	Total Score
   1
   2
   3
   4
   etc

   
   
   
5. Take around 40 of your existing films, and score them. You will find out what the common problems are, and also whether you are meeting your standard.
   
   
6. Modify your standard (up or down) if necessary.
   
   
7. Decide what changes you want to implement. For example, if coning off is a common problem, you may want to try a different film holding system. Or if poor contrast is common, consider a system for changing the chemicals according to how many films have gone through.
   
   
8. Institute the changes.
   
   
9. Take another 40 or so films, and remeasure your performance. Are the problems solved? If yes, this cycle is finished.
   
   
10. If you are still not meeting your standard, implement more changes, and then re-measure.
    
    
11. Once your standard is met, re-audit every so often to ensure you are maintaining the improvements.