CLAUD-IT: Clinical Audit Implementation in Europe - a practical and multidisciplinary approach

CLAUD-IT is a 36-month project (September 2024 – August 2027) co-funded by the European Union under the EU4Health programme 2021–2027, EU4H-2023-PJ-05 Action grants for a project on implementation of the agenda for medical ionising radiation applications (SAMIRA action plan) – organisation of clinical audit campaigns as a tool to improve quality and safety of medical applications of ionising. The project brings together 13 beneficiaries and one affiliated entity from 10 Member States.

The objectives of the CLAUD-IT are to improve clinical audit practice in EU Member States, foster implementation of clinical audit in radiology and nuclear medicine, and thus improve quality and safety of patients.

There is strong scientific evidence that clinical audit is a key component to improve quality and safety of medical imaging. Therefore, the official recommendation is to implement them widely into clinical practice. In addition, according to the European Basic Safety Standards Directive, 2013/59/Euratom, all Member States are required to carry out clinical audits “in accordance with national procedures” by law. Nevertheless, in most EU member states, clinical audits are still not sufficiently implemented.

CLAUD-IT builds on the results of the QuADRANT and EU-JUST-CT projects as well as resources developed by the European Society of Radiology and European Association of Nuclear Medicine with the ultimate goal to further improve justification and optimization and hence the overall quality and safety of radiology and nuclear medicine procedures. An Implementation Board will be set up consisting of national implementation teams of the participating countries, including representatives from the national radiology and nuclear medicine societies, authorities/agencies in charge of clinical audit in the respective countries in order to plan wider rollout and support of clinical audit campaigns and to ensure clinical audit is embedded as a core element of the wider healthcare systems.

Clinical audits in radiology will be based upon ESPERANTO, ESR’s guide to clinical audit in radiology in its 3rd edition, with an updated 4th version being developed as part of the CLAUD-IT project. For nuclear medicine, a dedicated 1st version of ESPERANTO will be developed under this action. Additionally, CLAUD-IT will set up a training programme for auditors as well as supporting documents and guidelines. All materials released under this action will be collected and made available via an open access repository, which will act as a one-stop-shop with all information and resources concerning clinical audit for radiology and nuclear medicine.

The project will support Member States with implementation of clinical audit. CLAUD-IT will pilot audit campaigns in radiology and nuclear medicine in 9 EU Member States (Bulgaria, Croatia, Cyprus, Germany, Greece, Italy, Romania, Slovenia, and Spain) to foster implementation into clinical routine. Clinical audits will be performed in two rounds in the course of the project: During the first round the 12 hospitals that are members of the consortium will carry out clinical audit in radiology and nuclear medicine using three selected templates per specialty and following the common methodology developed within the project, adapted to their local settings, with the support of two external experts (one for each specialty). Following analysis of the feedback and consideration of the lessons learned, a second round of audits will be organized in additional 3–6 hospitals per participating country, recruited with the support of the Implementation Board and supported by two experts each from the local audit teams of the first round of audits.

CLAUD-IT: Objectives

• Assess the current state of the art in all 9 participating Member States to identify new developments since the completion of the QuADRANT project as well as existing infrastructures and stakeholders
• Prepare practical, concise and evidence-based audit material and related training material for radiology and nuclear medicine and to make these available in a central repository in order to provide a “one-stop-shop” for stakeholders
• Hold practical stakeholder training to conduct clinical audits under external guidance
• Raise awareness for the importance of clinical audit by communicating its mandatory character as laid down in the BSSD and explaining the great impact it can have on daily professional practice as well as its contribution to higher quality care and patient safety. Convene the stakeholders in an effort to develop clinical audit strategies and campaign

Contact:

CLAUD-IT is led by the European Institute for Biomedical Imaging Research.

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