Audit means ‘official inspection of an organization’s data or finances, typically by an independent body’. A medical audit provides systemic feedback to health authorities about the quality of medical care given. While most audits relate to financial matters, medical audits are used by health care professionals to evaluate, estimate, and improve the care of their patients in an organized way. These can be internal or external. With the help of audits, doctors learn about what they have been practising, comparing their results with other benchmarks, and thus changing their practice to improve its effectiveness.
Audit means ‘official inspection of an organization’s data or finances, typically by an independent body’. While most audits relate to financial matters, medical audits are used by health care professionals to evaluate, estimate, and improve the care of their patients in an organized way. These can be internal or external. A medical audit provides systemic feedback to health authorities about the quality of medical care that was being given. With the help of audits, doctors learn about what they have been practising, comparing their results with other benchmarks, and thus changing their practice to improve its effectiveness.
In audits, a comparison is made
between the patient care being given and standard protocols. An audit encourages
using the best clinical practices to provide meaningful feedback to doctors
and policymakers from previous experience.
Florence Nightingale conducted the first documented audit in 1853, which measured the death rate in a hospital during the Crimean war. This was reduced from 40% to 2% by applying simple hygienic measures. A medical audit is now compulsory in most western countries. Still, its practice is rare in developing nations, largely due to a lack of awareness, commitment, and adequate medical records. The other reason for its absence is perceived as a threat to clinical freedom.
Clinical audits have existed in some form or another for over 100 years in developed countries. There are specific laws for health care units, doctors, and paramedics in these countries. Clinical audits in the developed world focus on patient outcome measures. There are deliberate efforts to improve patient care, and many Quality Improvement programmes are used. In the UK, the National Health Service has a special audit system called ‘The National Clinical Audit and Patient Outcomes Programme’ and in America, the ‘American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP)’ is a validated, risk-adjusted, outcomes-based programme to measure and improve the quality of surgical care.
An audit can be based on different determinants of the quality of care. They include:
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