white tick with excellent, good, average, poor and male hand

The standard: describes the level of care to be aspired to for any particular criterion

An example would be that 80% of people with CHD should have had their total cholesterol tested within the last 12 months

The level of standard can often be contentious, especially at the beginning of the audit process and it is recommended that agreement is reached within the audit project group as to the standards to be adopted. When applying standards it is recommended that the following 3 options can be considered;

An ideal standard:                  

The care it should be possible to give under ideal conditions, with no constraints

An optimum standard:         

Represents the standard of care most likely to be achieved under normal conditions of practice

A minimum standard:   

The lowest acceptable standard of performance

In the main standards should be set at least at optimum and should obviously strive towards the ideal accepting the fact that if ideal standards are made explicit that the audit process may never reach that level

When considering a new service, or indeed examining practice for the first time in a particular area, minimum standards may be adopted however as time progresses the standard should be revised upwards as appropriate

Where do standards come from?

Use standards defined by others if you can as it saves time and energy. However, check that they apply to your population and that they are from a credible source. There may be national standards published, such as those published by the National Institute of Health and Clinical Excellence (NICE). You may find peer reviewed articles containing recommended standards or contact PCQIS who can provide this information. Make sure everyone in your team finds them acceptable and is "signed up" to achieving them


For criteria / standards to be valid and lead to improved care, they must be:                       

  • Based on evidence
  • Related to important aspects of care
  • Measurable



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