19 - Audit in anaesthesia

Summary

Introduction

Audit in anaesthesia involves setting standards of anaesthetic practice, monitoring the application of those standards, measuring the outcome of care, identifying strengths and deficiencies, and implementing changes that improve clinical practice. The specialty of anaesthesia is valuable for audit research because in the UK anaesthetists are the most numerous of all hospital doctors, they have more direct patient-contact time concentrated into a relatively shorter period than other speciality, the care is usually provided at a one-to-one level or higher and anaesthetic responsibilities can be clearly defined.

In the United Kingdom, audit of anaesthetic practice occurs at a national and local level. At national level the College of Anaesthetists is responsible for formal examination of anaesthetists in training and for inspecting hospitals for postgraduate training and accreditation. College tutors are appointed in individual hospitals to provide a direct link with the college and to exercise an important pastoral role for the trainees. Together with the Association of Anaesthetists of Great Britain and Ireland, the college sets standards relating to the structure of anaesthetic departments and the work which they perform. While these standards do not carry legal weight, failure to meet a basic minimum level may result in hospital accreditation for junior training being withdrawn, a powerful stimulus for corrective action.