Background

In 1996, The Royal College of Radiologists (RCR) published Clinical Audit in Radiology: 100+ Recipes, edited by Gerald de Lacey, Ray Godwin and Adrian Manhire. This was an invaluable resource to many of us as we struggled with the concept of undertaking audit in a systematic and logical way, repeating the cycle and above all choosing audits which were relevant and not too challenging to busy radiologists.

In 2000, the authors followed with Clinical Governance and Revalidation: A Practical Guide, to meet the challenges of producing evidence on quality of care in a department of clinical radiology.

Both these publications were much used by members and Fellows as seen by the posters submitted to the Annual Scientific Meeting Poster Competitions, but both were in need of updating. The Clinical Radiology Audit Committee of The Royal College of Radiologists set themselves this task.

Several drivers emerged while the project was under way. The first was the realisation that revalidation was unlikely to take the form of an examination, but would probably include assembling a portfolio of good practice of which personal audit would be a component.
One of the original objectives of Clinical Governance and Revalidation: A Practical Guide was to assist individual members and Fellows in relation to the audit element of their work for revalidation by identifying those audits that meet the needs of governance and that will also be useful within a personal folder containing evidence in support of revalidation. This aim remains just as relevant today with revalidation under way.

In 2006, the Chief Medical Officer's report Good Doctors, Safer Patients called for the reinvigoration of clinical audit to enable it to reach its potential as a rich source of information to support service improvement, better information for patients and other activities such as revalidation of clinicians.

In updating the two publications, the CR Audit Committee endeavoured to remain true to the principles laid out originally with regard to standards and targets. Using the best available evidence, common sense and adhering to the requirements of clinical governance should still remain the underlying principles when defining a standard and when setting a target.
Several opportunities result from the way this collection of audits has been created in the web-based format. It provides a fully searchable menu of topics which can be used by a department when planning the annual forward programme in clinical audit. This is likely to be an important aspect of accreditation of departments.

AuditLive will assist individuals who wish to evaluate a particular area of local practice for their revalidation portfolio but are uncertain how best to set about it, to seek a suitable methodology from among these templates.

All the templates for data collection can be downloaded in Word format and adapted for local or individual use. Users can submit their own templates, hence spreading good practice, and it creates the opening for identical regional or national audits to be carried out by different centres. None of the templates is fully comprehensive. The limitations of the format, even with the use of appendices, do not allow every detail of the audit cycle to be spelt out. For example, all templates move swiftly from stage 2 of the cycle (assessment of local practice) to stage 3 (comparison of findings with the standard) to stage 4 (listing the changes which might be indicated) without mentioning data analysis which will need to occur between each of these stages. This requirement for data analysis needs to be assumed within all the templates. However, the live web-based format will allow the AuditLive Editors to amend and expand following user feedback. If you have ideas for improvement, please let us know.

We hope you will enjoy using AuditLive and will find it useful for the challenges of audit, revalidation, and accreditation.


Acknowledgements
We are indebted to Gerald de Lacey, Ray Godwin and Adrian Manhire who were the inspiration for the Audit Committee; and to Chris Ryall and Peter Lumb for turning aspirations into reality with their technical expertise.
Thanks go to all the original ‘recipe’ authors who kindly updated their contributions. The Healthcare Quality Directorate of the Department of Health provided initial funding for this project.


Dr Rowena Warwick, Chair, Clinical Radiology Audit Committee and co-editor of AuditLive
Dr Karen Duncan, co-opted member of the CR Audit Committee and co-editor of AuditLive