Drawing a line between research and audit

Citation

Wright, J. (2006), "Drawing a line between research and audit", Clinical Governance: An International Journal, Vol. 11 No. 2. https://doi.org/10.1108/cgij.2006.24811baa.001

Drawing a line between research and audit

Does this project need ethics approval? What is the difference between an audit and a research study? Do I need consent for my quality improvement project? These are questions that continually echo in the research and quality departments of health organisations around the world.

Researchers have become accustomed to the paper chase required to ensure that their project meets the exacting standards for legal and ethical research in today’s society – patient consent, patient information, data confidentiality, ethical review, financial governance, research governance, organisational sponsorship and compliance with international trial directive legislation.

However, researchers are becoming an increasingly professional cadre with the systems and support required to jump the endless hurdles of the research race. For most clinical staff these governance barriers are just plain off-putting. While this may not be such a big loss in the increasingly competitive field of research, it poses a huge challenge to keeping staff involved in quality improvement.

Good quality improvement programmes are dependent on continuous review and change. If we start to introduce unnecessary bureaucracy to this cycle, then any such progress will wither and die. In this issue of Clinical Governance Alison Hill and Neil Small review the literature on the differentiation between research and audit and provide some valuable insight into what is required to ensure quality improvement continues to be supported in health services.

Ultimately common sense must prevail in decisions about what projects require ethical and governance approval. If a project aims to audit practice or improve patient services, then this should be the legitimate domain of all clinical teams. Most patients can clearly distinguish work that aims to improve clinical services from studies that are clinical research.

Elsewhere in this issue we have examples of such audits and quality improvement projects – improving the efficiency of hospital services in urology and childhood immunisations, improving care in women with diabetes in pregnancy. This is no reason to be complacent about standards of audit and clinical governance. Shah and colleagues show that although their programme of departmental audit has been effective, they did identify projects that were left unfinished, and potentially wasted valuable time and resources. So let’s drop the bureaucracy, but not the standards.

John Wright