CLINICAL AUDIT PROPOSAL FORM
1. Short Title of Audit: Audit in Post-Operative Documentation in Trauma and
Casualty
2. Details of Project Lead
Project Lead: Name: Mehfujul Hassan Designation: Specialty
Rimel Registrar, Department of
Casualty, Trauma and
Emergency Surgery, PMCH
Contact details: E-mail: Phone:+8801722521014
mehfujulhassan@[Link]
3. Details of Audit Lead:
Audit Lead: Name: Prof AMSM Designation: Director and
Sharfuzzaman Chief Consultant, Department
of Casualty, Trauma and
Emergency Surgery, PMCH
4. Date plan completed: 12th November, 2025
5. Rationale for Audit:
Post operative surgical documentation is a critical component of patient care and
ensures seamless communication among health care providers. In this audit we
evaluated the quality of Casualty and Trauma operative notes against the RCS-England
guidelines aiming to improve adherence to these guidelines.
It plays a pivotal role in ensuring effective patient care, enhancing patient safety,
shortening their hospital stay and providing a legal protection for healthcare providers.
6. Based on your audit rationale how would you classify this audit?
This is an external must-do ◻ This is an internal Trust must-do ◻
(e.g. National audit or contractual requirement such as (e.g arising from Trust objectives/ risks/ incidents /
CQUIN) complaints/ NICE guidelines compliance etc)
This a Division/Service priority ◻ This is an individual clinician interest ◻
(e.g. part of Divisional or Team Service improvement (e.g. personal interest, personal development or as
priorities) part of an educational or training programme)
7. What standards will be audited?
List the audit standards being measured for compliance
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RCS - Good Surgical Practice Guidelines, Royal College of Surgeons, March 2025.
https:// [Link]/standards-and-research/good-surgical-practice/
☐Published guideline / standard ☐ Local standard
8. Do the audit standards cover the practice of one or more professional groups?
This is a Multi-disciplinary audit ◻ This is an Uni-disciplinary audit ◻
9. What methods will be used?
Type of Data Collection : Prospective
Data Source to be used: Case Notes
Method of data collection : Proforma
[Link] is your planned sample size?
Name of Service or Team and Division Planned Sample Size
50
Department of Trauma, Casualty and Emergency
Surgery
Total Sample Size: 50
11. What is your planned project timetable
Project Activity Person Estimated
responsible Completion
Date
Audit tool and or other audit material to be completed by: Dr. MD Rubaiath
Hossain
Data collection to be completed by: Dr. Arafat
Data inputting to be completed by: Dr. Shaptarshi
Data analysis to be completed by: Dr. MD Rubaiath
Hossain
Audit report to be completed by: Dr Mehfujul
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Project Activity Person Estimated
responsible Completion
Date
Hassan
Improvement action plan to be completed by:
12. Will this audit involve patients?
Yes. Prospective audit of patient management with review of post operative notes and
records
[Link] of Project Lead
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By completing this form you are agreeing to:
1. Complete the audit within agreed timescales
2. Ensure the audit results are disseminated to the Clinical Audit Department and all
relevant stakeholders
3. Return a copy of the completed data collection forms to the Clinical Audit Department
4. Agree any actions with the relevant stakeholders that are necessary to address where
any areas of non compliance have been identified.
[Link] of Audit Lead
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By completing this form you are agreeing to:
1. The suitability of the audit methodology and audit standards used to measure practice
[Link] that, where the audit results have indicated that best practice has not been met,
an action plan is developed and implemented to address the non-compliance
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