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Setting up district audit meetings in psychiatry

Published online by Cambridge University Press:  02 January 2018

David Roy*
Affiliation:
St Thomas' Hospital, London SE1 7EH
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Charles Shaw, in a number of articles and his Hospital Handbook (Shaw, 1989, 1990) has played a key role in outlining the principles of medical audit. He arbitrarily divides the process of medical audit into four phases. The philosophical phase which seems to have been negotiated, is whether the medical profession should be involved; the organisational phase; who should lead the process, and the resources required; the practical phase, what should be audited and the methods used; and the invasive phase, how the general concepts and the details of audit are communicated through publication. He goes on to describe a variety of methods of audit including the review of adverse events and general statistics, the assessment of randomly selected records, and finally the review of a topic (which includes medical record review). Another approach in planning audit is through understanding of the organisation itself (Donabedian, 1966) and evaluating quality of care in terms of the structure of the organisation (bricks and mortar, staffing, beds, technology etc.), the process of care, and this may include length of stay, broad out-patients statistics, and perhaps more controversially, face to face contact, group interaction, home visits, day hospital attendance and so on. Finally, and most complex, is outcome.

Type
Audit in Practice
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1991

References

Donabedian, A. (1966) Evaluating quality of medical care. Millbank Memorial Fund Quarterly, 44, 166206.CrossRefGoogle ScholarPubMed
Shaw, Charles (1989) Medical Audit. A Hospital Handbook. London: King's Fund Centre.Google Scholar
Shaw, C. D. (1990) Criterion based audit. British Medical Journal, 300, 649652.CrossRefGoogle ScholarPubMed
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