What stops effective clinical audit? Reports from the front line.

Semi-structured interviews were conducted with 145 clinicians from a variety of clinical backgrounds in twelve Trusts across three Scottish health boards. Questions examined barriers to the audit process and obstacles that impeded the implementation of changes in response to the audit findings as well as the need for resources to facilitate the audit activity. The most difficult part of the audit process was reported as data collection (32%) but almost half of respondents would have changed the way the audit was done with hindsight. The biggest barrier to doing the audit was perceived as lack of time (33%). Colleagues' attitudes posed the biggest obstacles to making changes as a result of the audit (26%). Few perceived the need for more resources but preferred focused and proactive support from managers and audit support staff: Trusts need to work harder at creating cultures where clinical audit is supported and actively encouraged.