Towards integrative audit: a partnership for quality

Outlines the gradual process which led to the development of the Sunderland Integrative Audit System. Centred around the Patient's Charter rights and standards, the various modules used together form a patient-centred, multidisciplinary approach to audit that can be used to monitor a contract, clinical directorate or specialty. Founded on the principle that health care is a complex, interactive process, the system seeks to establish the extent to which the patient experiences an "integrated" service by examining the interfaces between departments, professionals and services. Extensive piloting in diverse fields has found the system capable of being used in a variety of hospital and community settings.