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Related Experiment Videos

Should physicians perform their own quality assurance audits?

W J Brady1, D C Hissa, M McConnell

  • 1Department of Internal Medicine, University of Cincinnati, Ohio.

Journal of General Internal Medicine
|November 1, 1988
PubMed
Summary

Quality assurance audits improved preventive care ordering in clinics. Actively performing audits enhanced mammography screening, while passive review boosted vaccination rates.

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Area of Science:

  • Health Services Research
  • Medical Quality Improvement
  • Preventive Medicine

Background:

  • Hospital outpatient clinics require quality assurance (QA), but its impact on clinical practice is under-documented.
  • Evidence is limited regarding the effectiveness of QA audits in influencing physician behavior and improving patient care outcomes.

Purpose of the Study:

  • To evaluate the effect of QA audits on physicians' medical ordering practices.
  • To compare the behavioral impact of actively performing audits versus passively receiving audit results.

Main Methods:

  • A baseline of influenza vaccination and screening mammography ordering rates was established in a residents' clinic.
  • Residents were randomized into three groups: self-auditing for vaccination, self-auditing for mammography, or passive receipt of audit results.

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  • Ordering rates were compared across groups after the intervention period.

    • Main Results:

    • Passive receipt of audit results increased vaccination ordering from 40% to 59% and mammography ordering from 8% to 16%.
    • Active performance of audits significantly improved mammography ordering rates from 16% to 26%.
    • Active auditing did not yield significant improvements in vaccination ordering rates.

    Conclusions:

    • Quality assurance audits can effectively enhance the uptake of selected preventive health measures in resident clinics.
    • The method of audit engagement (active performance vs. passive review) influences the observed improvements in physician ordering behavior.
    • Further research is warranted to optimize QA strategies for different preventive services.