The Evolution of Clinical Audit as a Quality Improvement Tool in Gaza

Rationale, aims and objective Clinical audit plays a fundamental role in improving the quality of patient care and hence, is considered a cornerstone of clinical governance. This study evaluates clinical audit as a newly introduced quality improvement tool in the healthcare system of the Gaza Strip. Methods: Medical students and healthcare professionals who completed audits between 2015 and 2018 were invited to fill in an online survey from October 12 to November 2, 2018. Data was collected on applied methods, supervision, training, re-auditing and subsequent improvements in practice. Results A total of 62 audits was collected. Former training in clinical governance was received by 55 authors (88.7%) while a senior supervision was available in 56 audits (90.3%). Audits were performed across different hospitals and specialties with 18 audits (29%) in obstetrics, 16 audits (25.8%) in medicine and 11 audits (17.7%) each in surgery and paediatrics. A clear trend of increasing numbers of audits was observed with four audits (6.4%) completed in 2015 and 24 audits (38.7%) in 2018. Only 32 audits (51.6%) were presented to the local staff. The audit cycle was only completed in 14 projects (22.5%) with seven of them reporting improvements in practice. Conclusions A rise in the numbers of audits reflects a growing awareness of its key role in healthcare and patient safety. However, closure of loops and the actual implementation of recommendations are still lagging behind. Therefore, more focused efforts are needed to implement changes and ensure continuous evaluation of their effectiveness.