The topic to be audited should be locally common, or of high
health risk or high cost in other ways, and therefore should have
an important influence on outcome or resources. A preliminary review of
the reasons for referral to the occupational health service, problems identified
at consultations, "accident" rates, sickness absence rates and other major
resource commitments of the occupational health service should reveal many
possible topics for audit. Alternatively, a random review of consultation
records has the merit of being simple and of selecting common reasons for
consultation, although it would not cover all aspects of the work of an
occupational health service eg workplace assessment.
It is essential to have a standard against which to compare the observed
practice. However even where a rigid standard does not exist, an audit
to determine the variation in practice may be a useful starting point for
debate leading to the establishment of a valid standard.
Topics should be chosen in which there is likely to be the need
and the means for improvement in practice following comparison with
the standard and the implementation of change, and where the audit itself
is preferably simple, at least initially in the learning phase. Thus the
audit should start by seeking to improve education and practice
and then progress to improving outcome and efficiency through the implementation
of appropriate change.
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