Clinically, audit is the systematic, critical analysis of the quality of medical care. In order to indulge in audit it is necessary initially to identify an area of concern and define standards in that area. If there are none generally accepted in the field to be audited then they must be derived from a statement of the ideal situation, tempered with the expectation of current practice.
The advantages of audit are that it encourages education by discussion, can identify the means of improving clinical efficiency and, most importantly, it aims to improve the quality of medical care. Audit is a pointless exercise unless it results in beneficial change. The circle should be completed by monitoring the audit after a suitable interval to assess the extent of any change in practice and to see if there has indeed been an acceptable improvement in quality.
An audit of acupuncture practice in the rheumatology department of the Wycombe Health District resulted in better standardisation of acupuncture usage within the clinics and, by highlighting the degree of patient benefit from this treatment, a more enthusiastic acceptance of the technique by new members of the department. Improved care for patients was seen in the introduction of a check list of contraindications to acupuncture, better provision of information leaflets and explanation of side effects, and more detailed assessment of outcome with better communication with GPs.
Following this positive experience of audit, it is seen as an essential tool in the delivery of modern medical care, despite the time, commitment and hard work that successful audit demands.
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