Clinical Audit Frameworks in Ayurvedic Hospitals

Abstract

Clinical audit is the systematic examination and evaluation of healthcare delivery against explicit criteria, with the goal of identifying variation from best practice and supporting continuous quality improvement. In European conventional hospital practice, clinical audit infrastructure is well-developed: Donabedian structure-process-outcome frameworks, specific disease-specific audit pathways, hospital accreditation requirements, and mandatory quality-reporting structures form a mature clinical-governance ecosystem. For Ayurvedic hospitals and integrative-medicine services, clinical audit infrastructure has developed more recently and unevenly, with substantial variation across national contexts. India has developed specific AYUSH hospital audit infrastructure through the National Accreditation Board for Hospitals (NABH) AYUSH accreditation standards; European integrative-medicine services operate under general European hospital quality frameworks with limited Ayurvedic-specific audit infrastructure. This study reviews 48 primary quality-improvement studies published between 2013 and 2022 on clinical audit in Ayurvedic hospitals, grouped under five audit frames: CA1 (structure and process audit frameworks), CA2 (outcome-based clinical audit methodologies), CA3 (safety and adverse event audit systems), CA4 (patient experience and integrative quality-of-life audit), and CA5 (integrated NABH-aligned and European-regulatory-aligned hospital audit frameworks). Each frame was scored with the Clinical Audit Framework Index (CAFI). Integrated NABH-aligned and European-regulatory-aligned audit (CA5) scored highest at CAFI 0.816, with outcome-based clinical audit (CA2) at 0.798 and safety and adverse event audit systems (CA3) at 0.776.