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Related Experiment Videos

Medical audit--need for a positive commitment

M Rademaker1, N B Simpson, R J Motley

  • 1Department of Dermatology, Glasgow Royal Infirmary, UK.

Clinical and Experimental Dermatology
|January 1, 1993
PubMed
Summary
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Implementing policy changes after a case note audit significantly improved dermatology record-keeping. This audit circle approach demonstrated the importance of commitment to change and reinforcement of new policies for better clinical practice.

Area of Science:

  • Dermatology
  • Health Services Research
  • Medical Auditing

Background:

  • Clinical practice deficiencies were identified through an initial case note audit in 1987.
  • Policy changes were implemented in one dermatology unit (B) but not the other (A) following the initial audit.

Purpose of the Study:

  • To assess the effectiveness of a case note audit in improving clinical practice.
  • To evaluate the impact of policy changes on record-keeping in dermatology units.

Main Methods:

  • A criterion-based audit using an 18-question set was conducted on 200 new psoriasis referrals in 1987 and repeated in 1989.
  • Two dermatology units (A and B) were compared, with unit B implementing policy changes post-audit.

Main Results:

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  • Unit A, without policy changes, showed no improvement in record-keeping.
  • Unit B, with policy changes and established protocols, demonstrated a significant improvement (60% to 74% satisfactory completion, P < 0.0001).
  • Doctors in training grades showed the best performance and responsiveness to policy changes.

Conclusions:

  • Criterion-based audits are effective when there is a commitment to implement indicated changes.
  • Regular reinforcement of new policies across all medical staff levels is crucial for sustained improvement in record-keeping and clinical practice.