Clinical audit, quality improvement, and safety in palliative medicine

Abstract

Audit approaches and methods are now well advanced in palliative care, especially in clinical audit. This chapter discusses these approaches and methods, and addresses such questions as ‘Why perform clinical audit in palliative medicine?’ and ‘How do we assess the quality and safety of palliative care?’ It discusses the evolving terms of audit, quality assurance, quality improvement, safety, and governance, and how to apply clinical audit to palliative medicine. Audit requires resources, and so it must be sure to benefit patients and families, be kept as simple and efficient as possible, and have a strong educational component. There is also a need to develop and test methods of audit in a global healthcare context. If palliative approaches extend backwards to include patients earlier in care, rather than those just near to death, then the audit could become a means for clinical dialogue and education between specialties.