Emergency department chart auditing in a family practice residency program

A prospective audit of process on 1,200 consecutive patients seen in the emergency department by family practice residents was performed at the Family Practice Residency Program in Gainesville, Florida. The overall quality of care delivered conformed to the standards of "good medical care" as judged by the author in 85.6 percent of cases. Resident errors were detected in the remaining 14.4 percent of cases, and occurred most frequently among physicians in the earlier years of training (P less than .005). Ultimate patient management was changed by the audit in only 1 percent of cases but potentially had an important impact on the care of these patients. Errors of inadequate documentation were common among residents irrespective of their level of training. An ongoing audit of emergency department charts with regular feedback on medical process and recording appears to be useful both as an educational tool and as a method of improving emergency care.