Clinical Audits - a concept for their implementation in Switzerland

The key position in the organizational structure of Clinical Audits in Switzerland is filled by a group of experts. These experts are representatives of the stakeholders involved in the radiological processes such as radiologists, nuclear medicine professionals, radio-pharmacists, radio-oncologists, radiographers, medical physicists, and members of insurers and patient organizations. The group of experts is provided with the required authority by the Federal Office of Public Health. Its tasks are manifold: to define the guidelines for good clinical practice, to plan and coordinate audit programs and to instruct and advise the auditors. The actual clinical audits are carried out by a team of auditors. Auditors should be independent, competent and experienced. An audit lasts typically 2 - 5 days (depending on the complexity of the process to be audited) and covers the overall assessment of the radiological process. The results of the audit together with potential optimization methods are discussed at the end of the audit with the radiological department and are reported to the group of experts as well as to the Federal Office of Public Health. Results The result of a successful implementation of Clinical Audits in Switzerland is described by an Audit cycle. This cycle consists of the selection of a specific radiological process together with the corresponding guidelines for good clinical practice, assessing the local practice in the radiological department, comparing it with the guidelines, implementing changes when necessary, and re-auditing after a certain time. With each cycle quality improves which ultimately benefits patients.