The Impact of Clinical Audits on Improving the Healthcare System in Romania

Abstract

Background and Aim: Clinical audits are essential when it comes to improving healthcare quality by ensuring compliance with established standards. However, in Romania, clinical audits remain underdeveloped compared to other European healthcare systems despite their inclusion in the National Health Strategy 2023–2030. While audits are crucial in identifying inefficiencies and enhancing patient safety, their implementation faces limited resources, inconsistent application, and insufficient training. Our study aimed to evaluate the effectiveness of clinical audits in Romania and propose solutions for optimizing their implementation within the healthcare system in Romania. Materials and Methods: The study was conducted between April 23, 2024, and June 11, 2024, in several public hospitals in Romania. A mixed methods approach used quantitative data from structured surveys and qualitative data from interviews. Surveys were distributed by e-mail to health professionals registered on the National Authority for Quality Management (ANMCS) database. Participation was voluntary, and the sample consisted of professionals who responded to the invitation sent to official hospital contacts available on the ANMCS website. To increase the response rate, a follow-up reminder was sent by e-mail on June 6. Respondents had the option to continue with follow-up interviews to provide more detailed information regarding the importance of the audit. Data analysis involved statistical interpretation of survey responses and thematic coding for the qualitative data. Results: A total of 200 respondents participated in the study, including 73 heads of quality management (36.5%), 71 physicians (35.5%), and 56 nurses (28%). The majority of respondents were women (160, 80%). Regarding geographical distribution, 87% of the respondents were from urban areas, while 13% were from rural areas. Respondents from different rural areas participated, with the highest representation from urban medical centers. Most health professionals recognize the importance of audits in improving patient care. However, barriers such as inadequate education on audit processes, inconsistent implementation, and limited institutional support hampered their effectiveness. Hospitals with structured audit procedures demonstrated better patient outcomes and compliance with healthcare standards. Conclusion: Clinical audits are positively perceived by most participants. The findings highlight the need for regular audit activities in Romanian hospitals and their stronger integration into the healthcare system.