The internal audit of clinical areas: a pilot of the internal audit methodology in a health service emergency department

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Quality problem or issue

Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data.

Initial assessment

The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks.

Choice of solution

Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks.


The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines.


The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management.

Lessons learned

The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings.

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