Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)

You've Been Calling It An Audit. It's Actually A Quality Improvement Project. Here's The Difference.

This distinction quietly trips up candidates across every profession, every band, every specialty and panels notice when it's used incorrectly, because it suggests a gap in genuine understanding of clinical governance rather than just sloppy wording.

A clinical audit measures current practice against an established standard or guideline, identifies the gap, implements a change, and then re-measures to see whether the change actually closed that gap. It is fundamentally a measurement cycle compared against a standard, change something, and measure again.

A Quality Improvement Project is broader and often less rigidly structured around a single fixed standard. It uses structured methodology, frequently a Plan-Do-Study-Act cycle, to test and refine a change iteratively, often where no single national standard exists to audit against, or where the goal is genuinely a new service redesign rather than closing a gap against an existing benchmark.

Here's why getting this right matters on your CV and in your supporting statement. If you describe a genuine audit as a "QI project," or vice versa, an assessor with real clinical governance experience notices immediately, and it undermines confidence in the rest of your governance-related claims, even when the underlying work was genuinely strong.

The practical fix: before you write up any improvement work on your CV, ask yourself honestly which one it actually was. Did you measure against an existing standard and re-measure after a change? That's an audit.

Did you iteratively test and refine a new approach using a structured improvement methodology, often without one single fixed external standard? That's a QI project. Naming it correctly and being able to explain the distinction confidently if asked is a small detail that signals real governance literacy.

DM me "AUDITVSQIP" and I'll send you a simple framework for identifying which one any project you've done actually is.

Post 3 at 11 am: the NHS values question, and the framework that separates a memorised answer from a genuinely convincing one.

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You've Been Calling It An Audit. It's Actually A Quality Improvement Project. Here's The Difference....

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