Free audit report template 15

Version 3

Clinical Governance
Working Group

AUDIT REPORT
Centre:
Date:
Auditor:

MI Manager:
Designation:

Dates of previous
audits
Action points from previous audit

Comments

Summary of service

Date of preparation: July 2007
Date of review: Ongoing – as standards are updated.

1

Version 3

Summary of recommendations

Date of preparation: July 2007
Date of review: Ongoing – as standards are updated.

2

Version 3

Service Outline
A. Centre Profile
 Location of MI centre
 Management and reporting arrangements
 Service provision/user profile
 Publications:
 Out-of-hours enquiries
 PCT support
 Access to medical library:
 Involvement with local ADR reporting
 Involvement with formulary work
 Involvement with D & T Committee
 Involvement with Area Prescribing Committee
 Involvement with Medicines Management

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


Comments (brief description)

programmes
Involvement with Patient Group Directions
Ward/clinical work
Patient Helpline

Date of preparation: July 2007
Date of