8Criteria are items of care or some aspect of care that can be measured to assess quality. The National Institute for Clinical Excellence suggests the following definitions of a criterion

An item or variable which enables the achievement of a standard (broad objective of care) and the evaluation of whether it has been achieved or not (Royal College of Nursing, 1990)

  • A definable and measurable item of healthcare which describes quality and which can be used to assess it (Irvine and Irvine, 1991)
  • A systematically developed statement that can be used to assess the appropriateness of specific healthcare decisions, services, and outcomes

Criteria should;

  • Be explicit, write statements that define what is being measured
  • Represent elements of care that can be measured objectively

Structure         

  • All patients requesting an urgent appointment will be seen the same day 

Process           

  • All patients taking thyroid replacement therapy should be seen at least once within each fifteen months for an annual review of medication and baseline observations

Outcome         

  • All patients on Levothyroxin should have their TSH levels within the recommended range

An example of a criterion could be; — All patients with diabetes should have had their HbA1c measured within the last 12 months

Criteria should have the following attributes (CGSDU 2002);

Relevant

  •  Understandable
  •  Measurable
  •  Acceptable

It is important that the people involved are in agreement and amenable to making changes if necessary

Achievable

Be realistic about what you can do. Be aware of your resources, people, time, equipment, money etc

Finally, try to keep the number of criteria to a maximum of 2 or 3 (It is perfectly acceptable - and indeed may be desirable - to have only one criterion for an audit)

It is recommended that criteria are sourced from the best available current evidence, such as that contained within;  

  •  National or local guidelines (where they exist)
    •  Previous audits done by yourself or local colleagues

· Research articles, consensus statements, meta-analyses, Cochrane database and, where appropriate, should be agreed as a result of team discussion.