Audit / QIP Ideas

Overview

Audit and Quality Improvement (QIP) projects are not about producing groundbreaking research.
They are about showing that you:

  • Care about patient safety
  • Understand clinical standards
  • Can analyse practice
  • Can implement change
  • Can reflect on impact

When done well, they are powerful for portfolios and training applications.

Audit vs QIP (Simple Explanation)

Audit
Compares current practice against a recognised standard (e.g. NICE, trust guideline).
Example: Are all stroke patients getting HbA1c tested on admission?

QIP (Quality Improvement Project)
Focuses on improving a process over time using small, repeated changes.
Example: Introducing a checklist to improve documentation quality on ward rounds.

Both are equally valuable.

What Makes a Strong Project

Good projects are:

  • Simple
  • Relevant to your department
  • Easy to collect data for
  • Based on real guidelines
  • Able to show change

Bad projects are:

  • Overly ambitious
  • Hard to measure
  • Dependent on multiple departments
  • Impossible to complete within your rotation

Small and complete beats big and unfinished.

High-Yield Audit & QIP Ideas (Junior Doctor Friendly)

Acute Medicine / Medical Wards

  • Compliance with VTE assessment within 24 hours
  • Antibiotic review at 48–72 hours
  • Sepsis 6 completion rates
  • NEWS documentation accuracy
  • Escalation documentation for deteriorating patients
  • ECG within 10 minutes for chest pain
  • Blood glucose monitoring in diabetic admissions

Surgery

  • VTE prophylaxis prescription
  • Antibiotic prophylaxis timing in theatre
  • Post-op analgesia documentation
  • Consent form completeness
  • Documentation of complications

Care of the Elderly

  • DNACPR documentation quality
  • Capacity assessments documented
  • Falls risk assessment completion
  • Delirium screening use

Paediatrics

  • Weight documented for all admissions
  • Allergy status recorded
  • Safeguarding concerns documented

Cross-Specialty (Easy to Do Anywhere)

  • Discharge summaries completed within 24 hours
  • Allergy documentation on drug charts
  • Documentation of senior review
  • Weekend handover quality
  • Cannula review documentation

These projects are realistic, valuable, and achievable.

The Easiest Structure for Any Project

You can teach users this simple framework:

  1. Identify a problem
  2. Find the guideline/standard
  3. Collect baseline data (10–30 patients)
  4. Analyse gaps
  5. Introduce one small change
  6. Re-audit after change
  7. Reflect on outcome

This alone is enough for:

  • Portfolio evidence
  • Interviews
  • Teaching presentations

What Panels Actually Care About

They are not looking for perfect statistics.
They are looking for:

  • Insight
  • Ownership
  • Reflection
  • Learning
  • Impact

A simple project with good reflection scores better than a complex project you barely understand.

Common Mistakes

  • Choosing projects too big
  • Collecting data but never closing the loop
  • No guideline reference
  • No reflection on what didn’t work
  • Waiting too long to start

Start small. Finish well.

Reality Check

Almost every successful training applicant has done simple projects, not impressive ones.
What made them strong was clarity, not complexity.

Reassurance

You do not need research skills to do a strong audit or QIP.
You need curiosity, organisation, and follow-through.

That is achievable for any junior doctor.