Step 5: Audit
The final step of evidence-based practice (EBP) involves auditing, which encompasses two strands:
- Self-evaluation and evaluation of the EBP process: Reflecting on one's own performance and assessing the effectiveness of the entire evidence-based practice process, from literature review to implementation, to identify areas for improvement and ensure adherence to best practices.
- Evaluating changes in practice: Assessing the impact and effectiveness of implementing evidence-based recommendations or interventions within a clinical setting, measuring outcomes to determine the extent to which practice has been modified or improved based on the evidence.
Self-evaluation and evaluation of the EBP process
Self-evaluation plays a pivotal role in enhancing clinical expertise within the context of EBP. It serves as a mechanism for clinicians to scrutinise their own performance and systematically evaluate the efficacy of the entire EBP process. Through self-evaluation and self-reflection, clinicians can identify areas of strength and weakness, pinpoint areas for improvement, and ensure adherence to best practices, ultimately leading to enhanced patient outcomes.
Seeking constructive feedback from peers and colleagues can also facilitate self-evaluation. Clinicians can participate in peer review sessions, case discussions, or interdisciplinary team meetings to receive insights and perspectives from others in their field. Peer feedback provides valuable external perspectives and can highlight blind spots or areas for improvement that may not be apparent during self-assessment alone.
Tools:
- Self-evaluation Approaches: Evidence Based Medicine Toolbox
- The Clinical Excellence Commission: Tools and tip sheets for reflective practice
- Critical reflection for assessments and practice: Library guide that provides strategies, tools and ways of thinking to build your critical reflection skills
Evaluating changes in practice
Clinicians must measure the impact and effectiveness of the changes made, providing valuable insights into whether the desired outcomes have been achieved and if practice has been modified or improved in line with the evidence.
Evaluating changes requires continuous data collection and outcome measurements. Clinicians should ensure that all changes are recorded against the baseline, to establish the effects of their intervention. This includes engaging with their patient to ensure their perspectives are included.
Quality improvement (QI) is invaluable for assessing changes in practice due to its emphasis on measurable outcomes and continuous evaluation. By utilising data-driven decision-making processes, practitioners can objectively determine the effectiveness of implemented changes and make necessary adjustments. QI also ensures a focus on patient outcomes, promoting interventions that align with patient needs and preferences. Ultimately, QI facilitates a systematic and evidence-based approach to evaluating practice changes, leading to improved quality of care and better outcomes for patients.
Audit tools in healthcare fulfill a range of functions, including quality improvement through pinpointing areas for enhancement in clinical practice and patient care, monitoring compliance with best practices, measuring performance indicators, assessing and mitigating risks to bolster patient safety, and offering educational resources for healthcare professionals to facilitate continuous learning and development.
Tools:
- Quality Improvement (QI) Essentials Toolkit (Institute for Healthcare Improvement)
- Quality Improvement Toolkit (Clinical Excellence Commission)
- Internal Audit Clinical Tool (IACT) Kit (Victorian Managed Insurance Authority)
- Audit tools for National Safety and Quality Health Standards (Queensland Government)