Other sources of information about problems might be patients' complaints and comments from members of staff. Normal audit cycle theory starts off at standard setting. However, one of the major problems preventing practices getting started is lack of time needed to evolve protocols and apply for funding. This whole process can be so drawn out that the actual audit cycle never really starts to roll. After completion the team can meet to receive the results and to re-set standards.
Team work is the cornerstone of clinical audit.
Therefore, the first principle is that audit should be based on practice teams. The culture within the teams should permit the disclosure and discussion of deficiencies in care. There must be a system of management which supervises the collection of information, prioritises the problems that are discovered and selects them for further investigation through audit. Teams should organise meetings to discuss attitudes to audit and the meeting could then develop a written agreement deciding who should be in control of this system, the role of the practice manager and the means by which decisions are made. This is still the most difficult area of audit for teams and this people centred style of management is contrary to the hierarchical structure of medical training to which doctors are accustomed and, therefore, requires a significant shift in attitudes.