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An audit of paediatric audit in Scotland
Insights
Children in Scotland are an under-audited group, with most audits occurring in secondary care, not primary care. The Scottish Clinical Audit Project Register (SCAPR) data from 1992-1997 highlights this disparity.
Area of Science:
- Healthcare quality improvement
- Pediatric healthcare research
- Clinical audit methodology
Background:
- Clinical audit is crucial for evaluating and improving healthcare services.
- Understanding audit activity related to pediatric populations is essential for targeted service enhancement.
- The Scottish Clinical Audit Project Register (SCAPR) provides a dataset for analyzing audit trends.
Purpose of the Study:
- To review clinical audit activities in Scotland focusing on children aged 0-15 years between 1992 and 1997.
- To identify patterns in pediatric audit distribution across different healthcare settings and specialties.
- To assess the representation of pediatric patients within the overall audit landscape.
Main Methods:
- Retrospective review of the Scottish Clinical Audit Project Register (SCAPR) database.
- Inclusion of all healthcare specialties (including dentistry) in acute and community settings.
- Analysis of 7,073 registered entries to identify 613 pertaining to children.
Main Results:
- Only 9% of registered audits focused on children (0-15 years), despite children comprising 19% of the Scottish population.
- Greater Glasgow disproportionately contributed to audit entries (one-third) compared to its child population share (18%).
- Over half of the audits occurred in secondary care, with only 5% in primary care, indicating an under-representation of primary care settings.
Conclusions:
- Children appear to be an under-audited group in Scotland.
- Secondary care settings, particularly surgery, are over-represented in pediatric audits, while primary care is under-represented.
- The SCAPR requires improvements in data collection and recording to better identify specific service deficiencies and track audit loop closure.
Abstract:
We undertook a retrospective review of the Scottish Clinical Audit Project Register (SCAPR). This generated information on audit activities in Scotland relating to children aged 0-15 years over the period 1992 to 1997. All healthcare specialties (including dentistry) in both acute and community sectors were included. Of the 7,073 registered entries, 613 (9%) relating to children were identified. Greater Glasgow contributed a third of entries despite having only 18% of the child population. Over half the projects were conducted in secondary care settings and only 5% in primary care. Medicine and nursing appeared the most audit active professional groups. Our findings suggest that children (who comprise 19% of the Scottish population) are an under-audited group in Scotland. Secondary care (especially surgery) seemed over-represented and primary care under-represented as audit settings. We were unable to use the SCAPR to identify specific service deficiencies or improvements that may have been stimulated in the course of "closing the audit loop." Future refinements to the way data are collected and recorded on the SCAPR will clearly require to address this shortcoming.