BARRIERS TO EFFECTIVE CLINICAL AUDIT PRACTICE AMONG MEDICAL OFFICERS AND TRAINEES IN MARDAN MEDICAL COMPLEX

Abstract

Background: Clinical audit is an essential element in clinical governance and quality improvement, but its effective use in most healthcare environments, especially through frontline clinicians, is difficult.

Method: This cross-sectional descriptive study was carried out at a tertiary care teaching hospital between January and June 2025 to identify the barriers that affected the clinical audit practice among medical officers and postgraduate trainees. The structured self-administered questionnaire was used to gather data on the awareness of clinical audit, previous experience, and perceived organizational, resource-related, governance, and professional barriers. The analysis involved 50 completed questionnaires, which were analysed using descriptive statistics. Respondents were aware of clinical audit (58.0), 60.0% had already performed an audit, and 62.0% had undergone formal audit training. The main barriers that were identified were lack of protection of time (46.0%), lack of clerical support (56.0%), lack of access to clinical data (58.0%), fear of litigation (58.0%), financial constraint (58.0%), and absence of formal audit governance structures (66.0%). Only less than half of the participants were confident that audit results would be received or taken action. Nevertheless, 66.0% and 52.0% of participants reported collegial cooperation and interest in conducting audits, respectively.

Results: The results imply that effective and sustainable clinical audit practice can be improved by institutional support, audit governance, training, and development of a non-punitive audit culture.