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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
RapidMSRAMRCGP

Quality improvement and clinical audit

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Synopsis

Choose an appropriate improvement method, measure care against defensible standards, test changes safely, close the audit loop and demonstrate sustained patient-centred improvement.

  • Quality improvement is systematic work to improve patient outcomes, experience and service performance; clinical audit is a QI cycle that measures care against agreed evidence-based standards and remeasures after action.
  • Start with a specific patient or system problem, involve affected patients and staff, understand the current process and define a time-bound aim rather than beginning with a favoured solution.
  • The Model for Improvement asks what the team is trying to accomplish, how it will know a change is an improvement and what change may produce improvement.

Reasoning priorities

01
Baseline process map

Locate delays, duplication, handoffs and failure points before choosing change.

Map actual work with staff and patients; policy diagrams may not represent what happens under real demand.

Worked reasoning

Worked example: monitoring-result loopComplete a measurable PDSA and re-audit

Baseline review finds 27 of 50 eligible high-risk medicine monitoring episodes were completed, reviewed and communicated within the locally specified interval.

  1. Define the operational measure as completed plus clinician-reviewed plus patient-communicated episodes divided by all eligible episodes; validate the 54% baseline and map failure at test booking, result routing and recall.
  2. Set a twelve-week aim of 85%, co-design candidate changes and predict that a daily named inbox owner plus one combined reminder will reduce unowned results without increasing urgent wait time.
  3. Run the first PDSA with one clinician and ten due patients for one week, record deviations and measure completion, patient contacts and staff minutes; adapt reminder wording and backup ownership from the findings.
  4. The final action is staged adoption only after successive cycles show benefit; re-audit a comparable 50-episode cohort and verify sustainability with a run chart, patient feedback, urgent-wait balancing measure and a named monthly control-plan owner.
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Sources and review status7 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Apply principles in context and verify current guidance when a decision affects care. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom