- 期刊
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Organizational Facilitators and Barriers to Implementing Effective Clinical Audit: Systematic Review
並列摘要
BACKGROUND: Clinical audit is a systematic and critical analysis of ＂quality of care＂ to improve clinical care. This study was aimed to find organizational and managerial facilitators and barriers of effective clinical audit implementation in hospitals. METHODS: A systematic literature review was performed using the PubMed, Google Scholar and Cochrane databases with key words of ＂clinical audit＂, ＂effective audit＂, ＂evaluation of audits＂ and ＂medical audit＂ supplemented by hand-search. Content analysis was used to identify external and organizational factors that influence implementation of clinical audit. RESULTS: Of the 53 scientific articles about clinical audit, 4 core themes with 11 main themes and 50 subthemes related to negative factors affecting clinical audit and 5 core themes with 15 main themes and 92 subthemes about organizational facilitator factors were found. Resource limitation, poor information management system, lack of audit support centers, excessive workload and time constraint, lack of organizational support for building audit team, unavailability of evidence-based guidelines and bureaucratic hurdles were highlighted as organizational barriers in clinical audit. On the other hand, instructional support, effective training programs, participation of local ownership, high capacity for quality improvement, intensive feedback mechanisms, resource commitment and rational basis for allocation and evidence-based researches for setting standards are mentioned as factors which promote effectiveness of clinical audit programs. CONCLUSION: For clinical audit and its role in improving quality of care, identifying barriers, and facilitating factors in organizational setting can help managers and professionals to prepare the organizations which are suitable for implementing the clinical audits in proper manner.
延伸閱讀
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