Medical audit - need for a positive commitment

Rademaker, M., Simpson, N. B., Motley, Richard and Finlay, Andrew Yule ORCID: https://orcid.org/0000-0003-2143-1646 1993. Medical audit - need for a positive commitment. Clinical and Experimental Dermatology 18 (1) , pp. 17-20. 10.1111/j.1365-2230.1993.tb00958.x

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Abstract

Summary To assess the effectiveness of a case note audit in two dermatology units, the efiect of policy changes in clinical practice, made following the identification of deficiencies in practice by an initial audit in 1987, were evaluated 2 years later by repeating the audit process, i.e. 'completing the audit circle'. 'Fhe case notes (tf 200 new referrals of patients w ith psoriasis were audited, using a criteria set of 18 questions devised by a group of 66 dermatologists, in 1987 and again in 1989. Following the initial audit in 1987, policy changes were made at one centre (B) but not at the other (A). Tn the centre where no policy changes were agreed (A) there was no improvement in record keeping when re-audited in 1989. In centre (B), where a number of policy decisions were taken and protocols established, there was a highly significant improvement in record keeping (60';',, satisfactory completion of the criteria set in 1987 increased to 74% in 1989, P<0 OOOl). Doctors in training grades performed best and were most responsive to the policy changes. The effectiveness of a criterion-based audit depends on a commitment to change, where indicated, and regular reinforcement of new policies at ail levels of medical staff. One of the purposes of medical audit is to identify deficiencies in practice with the intention of rectifing them. We used a consensus criteria set to audit case notes of new patients with psoriasis in two centres. Following the initial audit, staff members discussed the findings but in only one of the centres were specific policies formulated in an attempt to improve the record keeping ofthe department. The audit process was repeated in both centres 2 years later to determine the value ofthe initial audil, and the subsequent policy changes, by monitoring any change in clinical practice.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General) R Medicine > RZ Other systems of medicine
Publisher:	Wiley-Blackwell
ISSN:	0307-6938
Last Modified:	27 Oct 2022 09:50
URI:	https://orca.cardiff.ac.uk/id/eprint/67913

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