The promotion and dissemination of good clinical audit practice is a high priority of the European Society of Radiology (ESR). The publication of an updated version of Esperanto, the ESR’s clinical audit guide, in 2019 was a key component of the ESR’s audit promotion initiative.

Clinical audit in radiological practices is a legal requirement set out under the recently implemented European Council Basic Safety Standards Directive (BSSD) 2013/59/Euratom and it has a key role in the continuous cycle of quality improvement in clinical practice.

ESR 2nd Vice President, Dr. Adrian Brady points out that clinical audit is central to modern medical practice.

“Clinical audit is central to modern medical practice, involving reflective validation of existing practices and identification of potential changes and improvements in the interest of patient safety and better outcomes. Radiology practice is ideally positioned to utilise the tools of clinical audit,” said ESR 2nd Vice President, Dr. Adrian Brady, from the department of radiology at Mercy University Hospital, Cork, Ireland, former ESR Quality, Safety and Standards Committee chair.

Effective clinical audit improves the quality of patient care by looking at current clinical practice, comparing it with accepted standards and modifying practice where necessary. It is now compulsory for BSSD compliance and there are required standards laid out within the BSSD. Most of these require a continued cycle of audit to demonstrate that standards are being adhered to and that compliance is being maintained.

“These audits should have clear and realistic objectives with achievable standards representing best practice. Audits that offer multidisciplinary involvement are to be encouraged, allowing all departmental staff to be engaged and to see the benefits,” said Prof. David Howlett, from the department of radiology at Eastbourne Hospital, UK, and Chair of the ESR Audit and Standards Subcommittee. “Audit timelines should be clear; results evaluation and dissemination are important, findings should be non-judgmental, and all parties should have a role in directing any necessary practice changes and future re-audit to ensure improvements are maintained,” he emphasised.

Cover of Esperanto, the ESR’s Guide to Clinical Audit.

With the aim of increasing awareness and understanding of clinical audit within radiology departments across Europe in accordance with the requirements of the BSSD, the ESR Audit and Standards Subcommittee has developed the Esperanto 2019 – ESR Guide to Clinical Audit in Radiology and the ESR Clinical Audit Tool. The aim of this publication is to support radiology departments in developing effective internal departmental clinical audit practices and processes as well as to encourage wider collaborations and external support for audit activities at a national level.

In the past year, the ESR Audit and Standards Subcommittee has undertaken a clinical audit project with the scope of assessing the logistical and administrative clinical audit infrastructure currently in place at both national and local department levels. Surveys were sent to European radiology departments through their national radiological societies and to EuroSafe Imaging Star departments.

After evaluating the initial results, a feedback survey was sent to EuroSafe Imaging Stars and national radiological societies with several aims. Indirectly, it was intended to assess the functionality of communication mechanisms at a national level between radiology departments and the respective national radiological society. Furthermore, the survey aimed to evaluate how external support of departmental audit by national radiological societies might work in reality – potentially with the ESR as the central hub. The survey also looked to assess direct departmental feedback on the clinical utility of Esperanto 2019 and current departmental clinical audit practices, processes and challenges.

Prof. David Howlett, Chair of the ESR Audit and Standards Subcommittee, highlights the importance of multidisciplinary involvement in audits, allowing all departmental staff to be engaged and to see the benefits.

It is recognised that in many European radiology departments clinical audit is well established and functional with effective internal clinical audit processes. For many radiology departments, however, there remains work to be done regarding compliance with BSSD clinical audit requirements in some areas. Clinical audit infrastructure is relatively underdeveloped in many member states at both national and local levels, which is a barrier to effective external direction of national clinical audit activity. Although departmental feedback on the ESR Esperanto clinical audit guide was generally very good, awareness of this publication was not widespread among radiology departments.

“Following these efforts, the ESR will continue to work collaboratively with governmental organisations, national radiological societies and radiology departments across Europe to further promote the importance and benefits of effective clinical audit and to improve patient safety and quality of care across Europe,” Prof. Howlett concluded.

Coffee & Talk Sessions,
Wednesday, November 11, 17:00–18:00
C 14 Clinical audit and the European-Basic Safety Standards (EU-BSS): where are we now?

Organised by the ESR Subcommittee on Audit and Standards

  • Chairperson’s introduction
    David C. Howlett; Eastbourne/UK
  • Clinical audit: EU-BSS uptake, the ESR perspective
    Adrian Brady; Cork/IE
  • Clinical audit: EU-BSS uptake, the regulator perspective
    Alexandra Karoussou-Schreiner; Luxembourg/LU
  • Case example: clinical audit template
    Tanja Holter; Oslo/NO
  • Live Q&A: To discuss the potential for future pan European projects

Professional Challenges Session
PC 5 Audit and value in clinical radiology: enhancing quality
Jointly organised by the ESR Subcommittees on PIER and Audit and Standards

  • Developing and implementing a national audit programme
    Juha Suutari; Helsinki/FI
  • Audit and quality improvement: the UK perspective
    David C. Howlett; Eastbourne/UK
  • Clinical audit: the radiographer’s perspective
    Graciano Paulo; Coimbra/PT
  • Adding value in radiology
    James P. Borgstede; Colorado Springs, CO/US