Introduction
Clinical audits play a fundamental role in improving the quality of
clinical practice and patient safety 12 3. The audit cycle involves
observing practice, setting standards, comparing practice with
standards, implementing changes and finally observing new practice4 5 6. Closing the
audit cycle is essential to achieve sustainable improvements in
healthcare 2 7 8.
In practice, the cycle is often not completed, and the problems are left
unresolved, which can potentially result in clinical auditing being a
time- and resource-wasting activity 910 11 12.
Clinical audit was implemented relatively recently as a quality
improvement (QI) tool in the healthcare system of the Gaza Strip. For
example, teaching concepts of QI work and clinical audit were only
introduced into the curriculum of local medical schools in 2015. This
led to the completion of a number of audit projects by medical students
for the first time in 2015 13 1415. A notable rise of QI work conducted by medical
students was observed in the following years. In 2017, the Palestinian
Ministry of Health (MoH) and the Palestinian Medical Council (PMC)
introduced a general requirement for healthcare professionals, including
interns and residents, to partake in QI activities. These measures
sparked a wider engagement in audit activities as well as a broad
awareness of the importance of QI work amongst medical students and
healthcare professionals. However, evidence of monitoring of audit
activities and subsequent improvements in clinical practice is still
lacking. Consequently, concerns were raised regarding the effectiveness
of clinical audits in improving the quality of patient in Gaza
Hospitals.
Therefore, we decided to track and evaluate the clinical audits that
were conducted in the Gaza Strip between 2015 and 2018. We also aimed to
identify factors that would contribute towards producing more impactful
audits in order to improve the quality of patient care in Gaza
hospitals.