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Audit is a key quality assurance tool for healthcare services. The audit cycle enables services to measure their performance against recognised standards, devise, and then implement changes to maintain or improve care, and then reaudit to evaluate these interventions.1 One of the most difficult to manage and time consuming aspects of the audit cycle is the measurement of performance. The collection, collation, analysis and then timely reporting are key to maximise the impact of the audit. Traditionally, this work has been done using paper forms with the results transcribed to a spreadsheet for analysis. This approach is dogged by incorrect data entry during completion and transcription, potential data loss from multiple sites and delays during this stage of the audit cycle.
The advent of cloud computing has enabled web forms to be used to capture data directly to a spreadsheet and then automatically analyse and display them for the auditor. The first step to creating a Google web form is to set up an email account that includes a suite of Google applications, and the web form software is found within Google Drive. Setting up web forms is simple, and extensive help is available in text and video format.2 Data in web forms are captured using a range of question types that can be edited after their creation. The nine data types and their uses are shown in table 1.
Upon submission of a Google web form, the auditor is presented with a thank you message that can be enabled to provide links to a summary report and analysis of data submitted. All the data from web forms are written into a spreadsheet, and this can be exported in six different formats: (Microsoft Excel, OpenDocument format, PDF document, Comma Separated Values, Plain Text and Web page). The ability to readily capture and then export data allows for the rigorous evaluation of the quality of questions to ensure that analysis and reporting are optimised before the link is distributed to the auditors. The link to the web form works on all computers and browsers; however, Microsoft Internet Explorer 7 is no longer supported for the development of Google web forms.
In May 2010, the British Association for Sexual Health and HIV (BASHH) South Thames Audit Group used a Google web form to audit against the new Commissioning for Quality and Innovation standard to enhance partner notification for patients with a new HIV diagnosis. The web form was written in 2 h, and then a link to it was distributed by email. Over 2 weeks, 209 patients were audited from 14 of the 17 clinics (71% response rate). One clinic was unable to complete the audit because the link to the web form was at that time blocked by the hospital's information technology department. Final analysis was completed within 2 h, and this was presented to the group 5 days after the audit closed.
The initial audit using a Google web form used a novel pseudo-anonymised key; however, following a BASHH National Audit Group3 review we decided that anonymous submissions were preferred.4 All web forms have clear instructions in the preamble reminding auditors that no patient-attributable information should be submitted. Additionally, the mandatory inclusion of the auditor's email address enables attribution of the data submissions.
The charity, Brook (http://www.brook.org.uk), performed four anonymous national audits in 2012 using Google web forms. All 18 UK centres submitted data (100% response rate) from 40 clients within the audit 3-week window and reports were produced and the data returned to each centre within 1 month of audit closure. In total, the care provided to over 3000 clients was captured during this audit programme without any difficulties encountered.
There is a clear opportunity to unlock the full potential of audit using Google web forms. Why don't you give it a go?
Contributors I would like to thank the members of the BASHH National Audit Group for their support.
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.