Obstacles to medical audit: British doctors speak

Area of Science:

• Healthcare Management
• Medical Practice Improvement
• Clinical Governance

Background:

• Government, managers, and professional bodies are promoting medical audit among British doctors.
• Understanding the challenges doctors face is crucial for effective audit implementation.

Purpose of the Study:

• To identify and categorize the obstacles encountered by doctors when introducing medical audit.
• To inform strategies for improving the implementation of medical audit in clinical settings.

Main Methods:

• Interviews were conducted with doctors across general, geriatric, and accident and emergency departments in four district general hospitals.
• Participants included 28 consultants and 34 junior doctors.

Main Results:

• Doctors generally acknowledged the necessity of medical audit.
• Nineteen distinct obstacles were identified, grouped into perceptions of audit's role, practical considerations, audit's effects, and anxieties about its use.
• Criticisms focused on audit implementation rather than its core principles.

Conclusions:

• While some obstacles to medical audit can be addressed with practical measures, others necessitate changes in doctors' knowledge, beliefs, and attitudes.
• Overcoming these attitudinal barriers presents a significant challenge to successful audit implementation.