Files
pediatric-clinical-research/SOPs/SOP-004-Internal-Audit.md

310 lines
8.6 KiB
Markdown

# Standard Operating Procedure: Internal Audit
| Document ID | SOP-004 |
|-------------|---------|
| Title | Internal Audit |
| Revision | 1.0 |
| Effective Date | [DATE] |
| Author | [AUTHOR] |
| Approved By | [APPROVER] |
| Department | Quality Assurance |
---
## 1. Purpose
To establish a process for conducting internal audits to verify compliance with the Quality Management System, pediatric research regulations, and study protocols, and to identify opportunities for improvement.
## 2. Scope
This procedure applies to:
- Planned audits of QMS processes and procedures
- Study-specific audits of pediatric clinical trials
- Site audits of research facilities
- Supplier/vendor audits (if applicable)
- For-cause audits triggered by quality concerns
- Pre-study readiness assessments
## 3. Definitions
| Term | Definition |
|------|------------|
| Internal Audit | Systematic, independent examination of activities and documents |
| Auditor | Qualified individual conducting the audit |
| Auditee | Individual or department being audited |
| Audit Finding | Observation of noncompliance or deficiency |
| Observation | Opportunity for improvement not constituting noncompliance |
| Critical Finding | Issue that poses immediate risk to child safety or data integrity |
## 4. Responsibilities
### 4.1 Quality Assurance Manager
- Develops annual audit program
- Selects and qualifies auditors
- Reviews and approves audit reports
- Tracks corrective actions
- Reports audit results to management
- Ensures pediatric-specific requirements audited
### 4.2 Auditors
- Conduct audits per plan and procedure
- Maintain independence and objectivity
- Document findings accurately
- Verify corrective actions
- Maintain confidentiality
- Understand pediatric research regulations
### 4.3 Auditee
- Cooperate with audit activities
- Provide requested documentation
- Respond to findings within timeframe
- Implement corrective actions
- Verify effectiveness
### 4.4 Management
- Support audit program
- Provide resources for corrective actions
- Review audit summaries
- Address systemic issues
## 5. Procedure
### 5.1 Annual Audit Program
1. Quality Assurance develops annual audit schedule considering:
- All QMS processes audited at least annually
- Risk-based prioritization
- Previous audit results
- Regulatory inspection history
- Active pediatric studies
- Changes to regulations or processes
- Sponsor/customer requirements
2. Audit schedule includes:
- QMS processes (Document Control, CAPA, Training)
- Clinical operations (protocol compliance, safety reporting)
- Regulatory affairs (submissions, communications)
- Data management
- Pediatric-specific processes (assent, parental permission, age-appropriate procedures)
3. Schedule approved by management
4. Schedule flexible to accommodate for-cause audits
### 5.2 Auditor Qualification
Auditors must demonstrate:
- Knowledge of QMS standards and regulations
- Understanding of pediatric research regulations (45 CFR 46 Subpart D, 21 CFR 50 Subpart D, ICH E11)
- Current GCP certification
- Audit training completion
- Independence from audited area
- Previous audit experience (for lead auditors)
### 5.3 Audit Planning
1. Assign auditor(s) and lead auditor
2. Ensure auditor independence (no audit own work)
3. Develop audit plan including:
- Audit objectives and scope
- Areas/processes to be audited
- Audit criteria (regulations, SOPs, protocols)
- Audit dates and estimated duration
- Personnel to be interviewed
- Documents to be reviewed
- Special pediatric considerations
4. Notify auditee at least 2 weeks in advance (except for-cause audits)
5. Request documents for pre-review:
- SOPs and work instructions
- Training records
- Study protocols and amendments
- Informed consent/assent documents
- Safety reports
- Regulatory correspondence
### 5.4 Audit Execution
#### 5.4.1 Opening Meeting
1. Introduce audit team
2. Confirm audit scope and schedule
3. Explain audit process
4. Answer questions
5. Establish logistics (workspace, access)
#### 5.4.2 Document Review
Review documents for:
- Compliance with regulations and SOPs
- Completeness and accuracy
- Proper approvals and signatures
- Traceability
- Pediatric-specific requirements:
- Age-appropriate consent/assent forms
- Proper parental permission
- Adherence to 45 CFR 46.408 categories
- Pediatric safety monitoring
- Growth/development assessments
#### 5.4.3 Interviews
- Interview key personnel
- Assess knowledge of procedures
- Verify training on pediatric requirements
- Evaluate understanding of child protection principles
- Assess competence in age-appropriate communication
#### 5.4.4 Observation
- Observe processes in action where possible
- Assess compliance with procedures
- Evaluate facility suitability for pediatric research
- Assess child-friendly environment
#### 5.4.5 Finding Documentation
For each finding, document:
- Specific noncompliance or deficiency
- Regulatory or procedural reference
- Objective evidence
- Risk level (Critical, Major, Minor)
- Location and date observed
Critical findings (immediate child safety risk):
- Report immediately to management and Principal Investigator
- Document interim actions taken
- Escalate per safety procedures
### 5.5 Closing Meeting
1. Present preliminary findings
2. Discuss observations
3. Clarify any misunderstandings
4. Establish timeframe for corrective action response
5. Thank auditee for cooperation
### 5.6 Audit Report
1. Lead auditor prepares audit report including:
- Executive summary
- Audit scope and criteria
- Areas audited
- Documents reviewed
- Personnel interviewed
- Findings (Critical, Major, Minor)
- Observations (opportunities for improvement)
- Positive practices noted
- Conclusion and overall compliance assessment
2. Report issued within 10 business days
3. Report distributed to:
- Auditee
- Auditee management
- Quality Assurance Manager
- Executive management (for critical findings)
- Principal Investigator (for study audits)
### 5.7 Corrective Action Response
1. Auditee submits CAPA response within:
- Critical findings: 3 business days
- Major findings: 10 business days
- Minor findings: 15 business days
2. Response includes:
- Root cause analysis
- Immediate corrective actions
- Long-term preventive actions
- Responsible person
- Target completion date
- Effectiveness verification plan
3. Quality Assurance reviews and approves response
4. If inadequate, response returned for revision
### 5.8 Follow-up Verification
1. Auditor verifies corrective action implementation
2. Verification methods:
- Document review
- Follow-up audit
- Process observation
- Records sampling
3. Verify effectiveness of actions
4. Document verification results
5. Close findings when satisfactorily addressed
6. If not effective, finding remains open and escalated
### 5.9 Audit Metrics and Reporting
Quality Assurance tracks and reports:
- Audits completed vs. planned
- Findings by type and severity
- Open vs. closed findings
- Overdue corrective actions
- Trends by area/process
- Repeat findings
- Pediatric-specific findings trends
## 6. Special Considerations for Pediatric Research
### 6.1 Assent and Consent Verification
- Review sample informed consent/assent forms
- Verify age-appropriate language
- Check IRB approval documentation
- Verify version control and participant records match
- Confirm proper signatures obtained
### 6.2 Pediatric Safety Monitoring
- Review adverse event documentation
- Verify growth and development monitoring
- Check pediatric-specific assessments completed
- Review DSMB reports if applicable
- Verify expedited reporting timelines met
### 6.3 Participant Protection
- Assess child-friendly environment
- Review child abuse reporting procedures
- Verify staff training on child protection
- Check privacy protections for minors
- Review parental permission documentation
### 6.4 Age-Appropriate Procedures
- Verify procedures modified for pediatric population
- Check age-specific normal ranges used
- Review accommodation for family participation
- Assess minimization of participant burden
## 7. Related Documents
- FRM-006 Audit Checklist
- FRM-007 Audit Report Template
- SOP-002 CAPA
- SOP-PED-001 Pediatric Assent Process
- SOP-SAF-001 Pediatric Safety Monitoring
## 8. References
- ICH-GCP E6(R2) Section 5.19 (Monitoring and Auditing)
- 45 CFR 46.103 (Assurance of Compliance)
- 21 CFR 312.56 (Review of Ongoing Investigations)
- ISO 19011:2018 (Guidelines for Auditing Management Systems)
---
## Revision History
| Rev | Date | Description | Author |
|-----|------|-------------|--------|
| 1.0 | [DATE] | Initial release | [AUTHOR] |