Audit has been defined as "the systematic critical analysis of the quality of medical care. This may include, for example, the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient." (Secretaries of State for Health etc., "Medical Audit:Working Paper 6" 1989).
Audit involves a process of repeating cycles which should result in a progressive improvement and eventually sustained assurance of quality in particular areas while identifying needs and methods of audit in new areas. This concept has been termed the "audit cycle":-
Set a standard of practice =>
Observe practice =>
Compare observed practice with standard =>
Implement change =>
(Back to re-setting a standard of practice)
Whatever topic is being audited or
method used, one hopes that the pattern described above follows naturally.
However, at what point does one start the cycle? (chicken or egg?). This
varies: if one has a valid standard of practice which enjoys consensus
support and a scientific basis, and relates to a common and important topic,
then one can start by comparing observed practice with the standard. If,
on the other hand, one is not sure of what topics merit audit or what standard
to follow, one should start by observing practice, choosing a topic and
starting the debate and search for information that leads to setting the
standard. The standard is not immutable and may change with subsequent
audit cycles. Therefore for practical purposes the cycle is rarely as simple
as that portrayed above.
This page is:
Raymond Agius © Copyright 1995-2007
NOW.... Consider the various reasons why audit is relevant to the practice of occupational health and medicine. Can you think of a couple? Make a brief note of them and only then proceed to the next page.