an agreed timescale for its completion. action plan development may involve refinement of the audit tool particularly if measures used are found to be inappropriate or incorrectly assessed. in other instances new process or outcome measures may be needed or involve linkages to other departments or individuals. too often audit results in criticism of other organisations, departments or individuals without their knowledge or involvement. joint audit is far more profitable in this situation and should be encouraged by the clinical audit lead and manager. re-audit: sustaining improvements after an agreed period, the audit should be repeated. the same strategies for identifying the sample, methods and data analysis should be used to ensure comparability with the original audit. the re-audit should demonstrate that the changes have been implemented and that improvements have been made. further changes may then be required, leading to additional re-audits. this stage is critical to the successful outcome of an audit process – as it verifies whether the changes implemented have had an effect and to see if further improvements are required to achieve the standards of healthcare delivery identified in stage 2. results of good audit should be disseminated both locally via the strategic health authorities and nationally where possible. professional journals, such as the bmj and the nursing standard publish the findings of good quality audits, especially if the work or the methodology is generalisable. clinical audit promotion while clinical audit makes great sense, there can be problems in persuading hospitals and clinicians to undertake and apply clinical audit in their work. nonetheless, in the uk clinical audit is one of the corpus of clinical governance measures that are required to be enacted throughout the nhs. outside the uk, hospital accreditation schemes, such as the trent accreditation scheme, have promoted the development and execution of clinical audit as a part of clinical governance in places such as hong kong and malta.