[How did health personnel perceive supervision of obstetric institutions?]

Through audits, the Norwegian Board of Health supervises and ensures that health institutions adhere to rules and regulations that apply to them. Conduct of such supervision should be predictable and the basis for decisions should be documented and challengeable. Those in charge of the supervision must have the necessary professional competence and be able to integrate and understand the collected information so they can draw the right conclusions. The audit team should demonstrate consideration and respect to those they meet during audits. We therefore wanted to study the experience of being audited among health care providers and leaders of institutions and subsequent adjustments after the audit.

We used a questionnaire to evaluate the national audit of 26 (of 60 totally) Norwegian obstetric institutions in 2004. A questionnaire was sent to leaders and health care providers in all institutions that had been inspected (208 persons). Data from semi-structured interviews were used to validate and explore the quantitative findings.

89% responded to the questionnaire. The supervision was well received by leaders and health care providers at the obstetric institutions. The respondents confirmed that the audit team's approach and conduct in principle adhered to the rules within the examined domains. The conclusions presented by the audit teams were accepted as correct by most of the respondents. A large number of adjustments were reported after the audits.

We conclude that auditing can lead to improvements and that the described programme probably contributed to improving obstetric services in Norway. The audit team's conduct seems to have an effect on acceptance of the supervision. The performance of the teams may have an impact of the acceptance of auditing, but not on reporting of the adjustments carried out.