Journal articles: 'Medical care Medical Audit'

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TOMLIN, P. J. "Intensive care-a medical audit." Anaesthesia 33, no. 8 (February 22, 2007): 710–15. http://dx.doi.org/10.1111/j.1365-2044.1978.tb08466.x.

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Glover, Gyles R. "Medical audit and mental health care." Psychiatric Bulletin 14, no. 6 (June 1990): 326–27. http://dx.doi.org/10.1192/pb.14.6.326.

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The recent prominence of medical audit in psychiatry is due in large measure to the place given to the subject in the government's White Paper Working for Patients (DoH, 1989a). However, medical audit existed before the White Paper and covers a broader scope than the White Paper proposes. Thus in considering the introduction of audit into the mental health services it is important not to allow the White Paper to narrow the field of view.

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Camacho, Luiz Antonio Bastos, and Haya Rahel Rubin. "Reliability of medical audit in quality assessment of medical care." Cadernos de Saúde Pública 12, suppl 2 (1996): S85—S93. http://dx.doi.org/10.1590/s0102-311x1996000600009.

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Medical audit of hospital records has been a major component of quality of care assessment, although physician judgment is known to have low reliability. We estimated interrater agreement of quality assessment in a sample of patients with cardiac conditions admitted to an American teaching hospital. Physician-reviewers used structured review methods designed to improve quality assessment based on judgment. Chance-corrected agreement for the items considered more relevant to process and outcome of care ranged from low to moderate (0.2 to 0.6), depending on the review item and the principal diagnoses and procedures the patients underwent. Results from several studies seem to converge on this point. Comparisons among different settings should be made with caution, given the sensitivity of agreement measurements to prevalence rates. Reliability of review methods in their current stage could be improved by combining the assessment of two or more reviewers, and by emphasizing outcome-oriented events.

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PALMER, R. HEATHER, and J. LEE HARGRAVES. "The Ambulatory Care Medical Audit Demonstration Project." Medical Care 34, Supplement (September 1996): 12–28. http://dx.doi.org/10.1097/00005650-199609002-00003.

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Bener, Abdulbari, Mariam Abdulmalik, Mohammed Al-Kazaz, Abdul-Ghani Mohammed, Rahima Sanya, Sara Buhmaid, Munjid Al-Harthy, and Mahmoud Zirie. "Medical Audit of the Quality of Diabetes Care." Journal of Primary Care & Community Health 3, no. 1 (October 14, 2011): 42–50. http://dx.doi.org/10.1177/2150131911414063.

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Objective: To assess the quality of diabetes care provided to patients attending primary care settings and hospitals in the State of Qatar. Design: Observational cohort study. Setting: The survey was carried out in primary health care centers and hospitals. Subjects and Methods: The study was conducted from January 2010 to August 2010 among diabetic patients attending primary health care centers and hospitals. Among the patients participating, 575 were from hospitals and 1103 from primary health care centers. Face-to-face interviews were conducted using a structured questionnaire including sociodemographic, clinical, and satisfaction score of the patients. Results: The mean age of the primary care diabetic patients was 46.1 ± 15.1 years and 44.5 ± 14.8 years for hospital patients ( P = .03). There was a significant difference observed in terms of age group, gender, marital status, occupation, and consanguinity of the diabetic patients in both medical settings ( P < .001). Overweight was less prevalent in primary care patients than in hospital diabetes mellitus patients (40.4% vs 46.4%). A significant variation was observed in the mean values of blood glucose (−0.76), HbA1C (−0.78), LDL (−0.01), albumin (−0.37), bilirubin (−0.76), and triglyceride (−0.01) in primary care patients compared to the mean values of the preceding year. Overall, complications were lower in primary care diabetic patients, and patients attending primary care were more satisfied with the diabetes care. Conclusion: The present study revealed that in general, primary health care provided a better quality of care to diabetic patients compared to that of hospitals. Also, primary care patients had a better satisfaction score towards diabetes care.

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Johnston, S. J. "Standards of care revisited – medical audit in practice." Psychiatric Bulletin 15, no. 5 (May 1991): 299–300. http://dx.doi.org/10.1192/pb.15.5.299-a.

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Crew, Suzanne. "Non-medical prescribing in secondary care: an audit." Nurse Prescribing 8, no. 10 (October 2010): 498–502. http://dx.doi.org/10.12968/npre.2010.8.10.78880.

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Guryel, E., K. Acton, and S. Patel. "Auditing Orthopaedic Audit." Annals of The Royal College of Surgeons of England 90, no. 8 (November 2008): 675–78. http://dx.doi.org/10.1308/003588408x318147.

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INTRODUCTION Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. PATIENTS AND METHODS We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. RESULTS Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. CONCLUSIONS A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change.

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Hatton, Paul, and Edward B. Renvoize. "Psychiatric audit." Psychiatric Bulletin 15, no. 9 (September 1991): 550–51. http://dx.doi.org/10.1192/pb.15.9.550.

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Medical audit has been defined “as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient” (Department of Health, 1989).

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Earnshaw, Jonothan. "Medical audit gave a falsely reassuring impression of the quality of medical care." Evidence-based Healthcare 2, no. 1 (March 1998): 18. http://dx.doi.org/10.1016/s1462-9410(05)80018-x.

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Fenton, George W., Brian R. Ballinger, C. Barbara Ballinger, and Graham J. Naylor. "Medical audit in a Scottish psychiatric service." Psychiatric Bulletin 14, no. 3 (March 1990): 136–39. http://dx.doi.org/10.1192/pb.14.3.136.

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Psychiatry is unique in already being subject to statutory external audit through regular visits to psychiatric hospitals and units by the Hospital Advisory Services and Mental Health and Mental Welfare Commissions. These organisations do comment on aspects of the standard and quality of care. Reports of their findings undoubtedly facilitate change. By their programme of repeated visits they are in a position to observe the implementation and outcome of altered patterns of practice brought about by their reports. The Codes of Practice being prepared by the Mental Health Commission (England and Wales) and Mental Welfare Commission (Scotland) is another step that will significantly influence clinical practice. Finally, the Royal College of Psychiatrists' postgraduate training scheme accreditation exercise, like those of the other Royal Colleges and Faculties, has had an impact on quality of clinical care through its policy of gradually increasing the standard of postgraduate clinical training requirements. Locally based audit clearly complements these external exercises and local psychiatric services are now expected to organise systems of regular internal audit as are the other clinical disciplines (Department of Health, 1989).

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Bhatt, R. V. "Professional responsibility in maternity care: Role of medical audit." International Journal of Gynecology & Obstetrics 30, no. 1 (September 1989): 47–50. http://dx.doi.org/10.1016/0020-7292(89)90214-2.

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Longstreet, Diane A., Marlene M. Griffiths, Deanne Heath, Gauwada Emily G. Marshall, Paolo Morisco, Nichelle Geary, Sarah Larkins, and Kathryn Panaretto. "Improving Diabetes Care in an Urban Aboriginal Medical Centre." Australian Journal of Primary Health 11, no. 3 (2005): 25. http://dx.doi.org/10.1071/py05039.

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The aim of this project was to improve the detection, monitoring, and medical care of Indigenous patients with diabetes in an urban Aboriginal medical centre. The research design and methods entailed the diabetes register being cleaned and updated. A pre- and post-project non-random sample audit of medical records of patients diagnosed with diabetes evaluated the level of care received compared to best practice standard of care. A multi-disciplinary Diabetes Team established procedures to improve the patient care provided. Additional service providers, including a dietitian, podiatrist, ophthalmologist, and endocrinologist, joined the team. A holistic health care approach was implemented with an emphasis on opportunistic care. The percentage of patients having a care plan completed increased from 18% in the 2002 audit to 72% in the 2003 audit. There were significant trends between increased completion of all cycle of care activities and frequency of GP review. Doctors prepared care plans for 50% of patients who attended less than two review visits in 2003, but increased to 89% if receiving six visits or more (p = 0.000). No significant improvement in health outcome was noted. The project showed significantly improved care planning and medical management of urban Aboriginal and Torres Strait Islander patients with diabetes.

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Scott, Judith A., and Mindy Camden. "Recovery Audit Contractor Medical Necessity Readiness." Professional Case Management 16, no. 5 (2011): 232–37. http://dx.doi.org/10.1097/ncm.0b013e31821ac720.

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&NA;. "Recovery Audit Contractor Medical Necessity Readiness." Professional Case Management 16, no. 5 (2011): 238–39. http://dx.doi.org/10.1097/ncm.0b013e3182285bed.

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McCarthy, Paul. "Implementation of a Regional Medical Control Audit System." Prehospital and Disaster Medicine 7, no. 2 (June 1992): 167–74. http://dx.doi.org/10.1017/s1049023x0003942x.

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The growth and development of emergency medical services (EMS) has been both impressive and extensive since the late 1960s. Since that time, there has been much discussion and debate regarding the level and quality of care that patients receive from the EMS system. In the United States, this has resulted in a wide variety of emergency medical technician (EMT) certification levels that determine which personnel administer an extensive range of medications, procedures, and medical protocols. Because of these differences, the care a patient receives varies not only from state to state but from community to community. Even though there are many different EMS system configurations, EMS professionals generally believe die level of care they provide in their local community is effective. It is unfortunate that very often, opinions about EMS system effectiveness are not based on studies of EMS system performance or patient outcome data, but upon subjective assessments of ongoing activities by those individuals providing the services.

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Gődény, Sándor. "Quality assurance and quality improvement in medical practice – Part 3. Clinical audit in medical practice." Orvosi Hetilap 153, no. 5 (February 2012): 174–83. http://dx.doi.org/10.1556/oh.2012.29293.

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The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised. Orv. Hetil., 2012, 153, 174–183.

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Aeyels, Daan, Luk Bruyneel, Peter R. Sinnaeve, Marc J. Claeys, Sofie Gevaert, Danny Schoors, Massimiliano Panella, Walter Sermeus, and Kris Vanhaecht. "Care Pathway Effect on In-Hospital Care for ST-Elevation Myocardial Infarction." Cardiology 140, no. 3 (2018): 163–74. http://dx.doi.org/10.1159/000488932.

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Objectives: To study the care pathway effect on the percentage of patients with ST-elevation myocardial infarction (STEMI) receiving timely coronary reperfusion and the percentage of STEMI patients receiving optimal secondary prevention. Methods: A care pathway was implemented by the Collaborative Model for Achieving Breakthrough Improvement. One pre-intervention and 2 post-intervention audits included all adult STEMI patients admitted within 24 h after onset and eligible for reperfusion. Adjusted (hospital random intercepts and controls for transfer and out-of-office admission) differences in composite outcomes were analyzed by a multilevel logistic regression. Results: Significant improvements in intervals between the first medical contact (FMC) to percutaneous coronary intervention (PCI) and between the door to PCI were shown between post-intervention audit II and post-intervention audit I. Secondary prevention significantly deteriorated at post-intervention audit I but improved significantly between both post-intervention audits. Six out of nine outcomes were significantly poorer in the case of transfer. The interval from FMC to PCI was significantly poorer for patients admitted during out-of-office hours. Conclusions: After care pathway implementation, composite outcomes improved for in-hospital STEMI care. Collaborative efforts exploited heterogeneity in performance between hospitals. Iterative and incremental care pathway implementation maximized performance improvement.

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Garden, Gillian, Femi Oyebode, and Stuart Cumella. "Audit in psychiatry." Psychiatric Bulletin 13, no. 6 (June 1989): 278–81. http://dx.doi.org/10.1192/pb.13.6.278.

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Medical audit has been defined as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient (DOH, 1989). The White Paper Working for Patients states that the Government proposes that every consultant should participate in a form of medical audit agreed between management and the profession locally. It also states that management should be able to initiate an independent professional audit.

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Akhtar, S. "Medical Audit of Appendisectomies in Rural Based Tertiary Care Centre." IOSR Journal of Dental and Medical Sciences 9, no. 2 (2013): 78–81. http://dx.doi.org/10.9790/0853-0927881.

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Bowley, Douglas M., D. Lamb, P. Rumbold, P. Hunt, J. Kayani, and A. M. Sukhera. "Nursing and medical contribution to Defence Healthcare Engagement: initial experiences of the UK Defence Medical Services." Journal of the Royal Army Medical Corps 165, no. 3 (August 4, 2018): 143–46. http://dx.doi.org/10.1136/jramc-2017-000875.

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IntroductionThe WHO Constitution enshrines ‘…the highest attainable standard of health as a fundamental right of every human being.’ Strengthening delivery of health services confers benefits to individuals, families and communities, and can improve national and regional stability and security. In attempting to build international healthcare capability, UK Defence Medical Services (DMS) assets can contribute to the development of healthcare within overseas nations in a process that is known as Defence Healthcare Engagement (DHE).MethodsIn the first bespoke DMS DHE tasking, a team of 12 DMS nurses and doctors deployed to a 1000-bedded urban hospital in a partner nation and worked alongside indigenous healthcare workers (doctors, nurses and paramedical staff) during April and May 2016. The DMS nurses focused on nursing hygiene skills by demonstrations of best practice and DMS care standards, clinical leadership and female empowerment. A Quality Improvement Programme was initiated that centred on hand hygiene (HH) compliance before and after patient contact, and the introduction of peripheral cannula care and surveillance.ResultsAfter a brief induction on the ward, it was apparent that compliance with HH was poor. Peripheral cannulas were secured with adhesive zinc oxide tape and no active surveillance process (such as venous infusion phlebitis (VIP) scoring) was in place. After intensive education and training, initial week-long audits were undertaken and repeated after a further 2 weeks of training and coworking. In the second audit cycle, HH compliance had increased to 69% and VIP scoring compliance to 99%. In the final audit cycle, it was noted that nursing compliance with HH (75/98: 77%) was significantly higher than the doctors’ HH compliance (76/200: 38%); p<0.0001.ConclusionsDHE is a long-term collaborative process based on the establishment and development of comprehensive relationships that can help transform indigenous healthcare services towards patient-centred systems with a focus on safety and quality of care. Short deployments to allow clinical immersion of UK healthcare workers within indigenous teams can have an immediate impact. Coworking is a powerful method of demonstrating standards of care and empowering staff to institute transformative change. A multidisciplinary group of Quality Improvement Champions has been identified and a Hospital Oversight Committee established, which will offer the prospect of longer term sustainability and development.

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Jones, E. "Audit in psychiatry: “failed discharges”." Psychiatric Bulletin 15, no. 1 (January 1991): 26–27. http://dx.doi.org/10.1192/pb.15.1.26.

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Medical audit has been defined as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patients (Department of Health, 1989). The medical profession has been under pressure to extend and improve audit procedures in recent years (McKee et al, 1989), but there have been doubts about the most satisfactory methods, particularly in psychiatry (Garden & Oyebode, 1989). There are numerous methodological problems in measuring the outcome of psychosocial care (Shaw, 1989; Royal College of Psychiatrists, 1989). Indicators of outcome which have been used in medicine include incidence of adverse events. Reintervention rates do offer some measure of outcome, and have been used widely in other medical specialities.

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Boros, Erzsébet, István Szél, and Zoltán Dénes. "The role of pharmacotherapeutical audit in the improvement of pharmacotherapy during inpatient rehabilitation care. Experience for the National Institute of Medical Rehabilitation, Hungary." Orvosi Hetilap 153, no. 25 (June 2012): 997–1002. http://dx.doi.org/10.1556/oh.2012.29368.

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Pharmacotherapy is one of the most important and dangerous area in hospital health care, that explains why innumerable efforts are made worldwide to improve this process and prevent mistakes. Although clinical audit is a well known and widely used method, it is very rarely used for this purpose and scientific papers dealing with this topic can be scarcely found. In the last 20 years different quality management systems were introduced into the Hungarian hospitals, but most of them are not specific for the medical care. The most important element of quality management systems is the internal, professional audit that serves patient safety. Aims and methods: Authors report their experience on pharmacotherapy audits performed for over a decade in the National Institute for Medical Rehabilitation, Hungary. They review the method of audit meetings in details and discuss the most frequent problems. Results: The results indicate that characteristics of therapeutic mistakes in the rehabilitation practice are similar to those reported in scientific literature. Conclusions: Improving knowledge on pharmacotherapy audits of rehabilitation specialists may be an important part of continuous professional advancement providing facility for dispute on other issues of patient care. Orv. Hetil., 2012, 153, 997–1002.

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Pollitt, Christopher. "The Politics of Medical Quality: Auditing Doctors in the UK and the USA." Health Services Management Research 6, no. 1 (February 1993): 24–34. http://dx.doi.org/10.1177/095148489300600103.

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Following the 1989 white paper Working for patients medical audit has emerged as the principal officially-approved means of assuring the quality of NHS medical care. Beneath the surface consensus, however, significant arguments continue concerning both the purposes and the character of such audit. A ‘medical model’ of medical audit is in competition with a more managerial approach, while consumer interests, however unsuccessfully, are also trying to claim a role. Comparison with the system of peer review in the USA indicates that medical audit in the NHS is likely to be particularly weak with respect to public accountability. Nevertheless, when taken together with other features of the white paper's proposals, the universalization of medical audit offers managers an opportunity to begin to constrain the behaviour of hospital doctors at the local level.

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SHACKFORD, STEVEN R., PEGGY HOLLINGSWORTH-FRIDLUND, MAUREEN MCARDLE, and A. B. EASTMAN. "Assuring Quality in a Trauma System—The Medical Audit Committee." Journal of Trauma: Injury, Infection, and Critical Care 27, no. 8 (August 1987): 866–75. http://dx.doi.org/10.1097/00005373-198708000-00004.

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Heath, D. A. "Clinical audit in hospital." Proceedings of the Royal Society of Edinburgh. Section B. Biological Sciences 101 (1993): 115–21. http://dx.doi.org/10.1017/s0269727000005698.

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SynopsisAudit within general medicine originated from a review of patient clinical records. The main effect of such activities was to lead to an improvement of documentation and a realisation that audit could be performed amicably. Once case note reviews had been established it was usually necessary to progress to specific topic review. Such audits required more input of doctors' time, and to be performed properly needed the support of committed audit staff and limited support from computer technology.The primary aim of medical audit is to improve clinical care. Although an important component it is not the primary purpose of audit to save money.

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Zimenkovsky, А. B., and T. G. Gutor. "Medical standard as a historical component on the way of clinical audit." Acta Medica Leopoliensia 26, no. 4 (2020): 108–15. http://dx.doi.org/10.25040/aml2020.04.108.

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Aim - the search, analysis and systematization of historical facts concerning the formation and evo-lution of the world medical standartization; severance of its certain long-standing models for the optimization of settling and introduction of the existing, and future analogs, particularly, in the clinical audit format. Material and Methods. In order to study the medical standard as a historical component the fol-lowing methods were used: bibliographic, historical, analytical and methods of systematization and comparison. Results and Discussion. As a result of the conducted research the main historical events in the world development of the medical standartization starting from 1500 up till nowadays were col-lected. In order to study the evolution of the medical standartization, the analysis of the normative documents that have regulated the process of standartization, especially the Doctor's statute(s) in Russia, Minimal standard of the medical equipment and works of the American college of surgeons, was carried out. The scientific works that initiated the introduction of the clinical audit in the Health Care system in Ukraine, Turkey, the USA and Great Britain were throroughly analyzed. Conclusions. The improvement of quality as to rendering the medical aid is a job priority in the health care systems in many countries. For that reason, the search for its optimization was and is still retrieved for many centuries. The territorial formation of medical standartization is associated with England, Russia and the USA, but the occurrence of clinical audit is connected with Ukraine, Turkey, the USA and Great Britain. The foundations of the medical standardization was lauched in 1500 year, while the clinical audit - in 1854 year. The medical standartization is a reflection of the history of development of the organization of health care system, that's why the expertness (knowl-edge) of historical stages concerning the setting and the introduction of medical standartization may give a new impulse in its improvement and development under present-day conditions of reforma-tion in the medical sphere in Ukraine. The earlier beginning of implementation of the medical stan-dartization in the health care system in different countries makes it possible to actualize its introduc-tion into the clinical audit format, that, in its turn, allows to improve the quality of rendering the medical aid. Key words: medical standartization, clinical audit, quality of medical aid

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Wilamowsky, Yonah, Aliza Rotenstein, and Sheldon Epstein. "Developing Transparent Health Care Reimbursement Auditing Procedures." Journal of Business Case Studies (JBCS) 10, no. 1 (December 31, 2013): 1–6. http://dx.doi.org/10.19030/jbcs.v10i1.8323.

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The continued computerization of health care records has enabled easier sampling and analysis of large sets of medical records, making it easier than ever for Medicare, Medicaid and other private insurers to use statistical audits to determine and demand return of alleged overpayments to health care providers. However, there are sometimes statistical difficulties with the audits, and there is frequently not sufficient transparency in the procedures or their application to reproduce the results in order to determine whether they have been carried out correctly. This paper addresses concerns in sampling and analysis of data records by looking at the case of a specific audit of a medical practice carried out by a private insurer. If done properly, statistical audits can be a very useful tool, but often the methodologies are vague and the implementation is either wrong or not explained fully enough to reproduce and analyze.

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Murtagh, Alan, Radu Petrovici, Wendy Wong, Curtis Obadan, Olufemi Solanke, Emmanuel Nnabuchi, and Kevin Kilbride. "Improving monitoring for metabolic syndrome using audit." Irish Journal of Psychological Medicine 28, no. 3 (September 2011): i—iv. http://dx.doi.org/10.1017/s079096670001226x.

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Audit has been defined as “a quality improvement process that seeks to improve patient care and outcome, through systematic review of care and comparison with explicit criteria, followed by the implementation of change”. As of May 2011, under the Medical Practitioners Act 2007, doctors are legally obliged to join in professional competence schemes, following requirements set by the Medical Council. These include the obligation for doctors to conduct one clinical audit per year. In Ireland and elsewhere, audit provides an opportunity for services to create an “environment in which clinical care will flourish”.

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Linnarsson, Rolf. "Medical audit based on computer-stored patient records exemplified with an audit of hypertension care." Scandinavian Journal of Primary Health Care 11, no. 1 (January 1993): 74–80. http://dx.doi.org/10.3109/02813439308994906.

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Dutta, A., R. R. Parker, and T. W. Fleet. "Audit in two acute psychiatric units." Psychiatric Bulletin 15, no. 6 (June 1991): 351–52. http://dx.doi.org/10.1192/pb.15.6.351.

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The Royal College of Psychiatrists (1989) has recently produced its own preliminary report on medical audit. It defines medical audit as: “The systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patients.” This definition is in essence similar to that of the Royal College of Physicians.

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Lindström, Kjell, Anders Hagman, and Calle Bengtsson. "Medical audit used for estimation of optimum level of outpatient care." Scandinavian Journal of Primary Health Care 13, no. 3 (January 1995): 175–81. http://dx.doi.org/10.3109/02813439508996758.

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Johan, A. "An audit of unplanned extubations in a medical intensive care unit." Critical Care 4, Suppl 1 (2000): P100. http://dx.doi.org/10.1186/cc820.

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Goldstone, Leonard A. "The quality of health care and the role of medical audit." Current Orthopaedics 5, no. 4 (October 1991): 259–66. http://dx.doi.org/10.1016/0268-0890(91)90021-q.

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Luke, L. C., S. Cusack, H. Smith, C. E. Robertson, and K. Little. "Non-traumatic chest pain in young adults: a medical audit." Emergency Medicine Journal 7, no. 3 (September 1, 1990): 183–88. http://dx.doi.org/10.1136/emj.7.3.183.

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Camp, A. V. "Acupuncture Audit in Rheumatology." Acupuncture in Medicine 12, no. 1 (May 1994): 47–51. http://dx.doi.org/10.1136/aim.12.1.47.

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Clinically, audit is the systematic, critical analysis of the quality of medical care. In order to indulge in audit it is necessary initially to identify an area of concern and define standards in that area. If there are none generally accepted in the field to be audited then they must be derived from a statement of the ideal situation, tempered with the expectation of current practice. The advantages of audit are that it encourages education by discussion, can identify the means of improving clinical efficiency and, most importantly, it aims to improve the quality of medical care. Audit is a pointless exercise unless it results in beneficial change. The circle should be completed by monitoring the audit after a suitable interval to assess the extent of any change in practice and to see if there has indeed been an acceptable improvement in quality. An audit of acupuncture practice in the rheumatology department of the Wycombe Health District resulted in better standardisation of acupuncture usage within the clinics and, by highlighting the degree of patient benefit from this treatment, a more enthusiastic acceptance of the technique by new members of the department. Improved care for patients was seen in the introduction of a check list of contraindications to acupuncture, better provision of information leaflets and explanation of side effects, and more detailed assessment of outcome with better communication with GPs. Following this positive experience of audit, it is seen as an essential tool in the delivery of modern medical care, despite the time, commitment and hard work that successful audit demands.

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Lo, CM, SH Leung, CS Lam, and HH Yau. "Clinical Audit on Short Stay Emergency Medical Admission." Hong Kong Journal of Emergency Medicine 10, no. 1 (January 2003): 30–36. http://dx.doi.org/10.1177/102490790301000106.

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The growth rate of emergency department visit locally is disproportionate to the population growth. The number of emergency hospital admission has also increased leading to congested ward environment. A retrospective clinical audit on short stay (discharged within 24 hours) emergency medical and geriatric admission was done to look at the appropriateness of our emergency medical and geriatric admission. This study was carried out in April 2000. The Appropriateness Evaluation Protocol was employed as an objective tool for initial assessment. A peer panel, composed of Fellows from the Colleges of Physicians and Emergency Medicine, was formed to check for appropriateness of admission for those cases without objective admission criteria. Thirteen out of the 177 cases (7.3%) available for analysis were considered as “inappropriate” admission. If we assume that those emergency admissions that stayed for longer than 24 hours were appropriately admitted, the “inappropriate” admission rate for medical and geriatric cases would be 0.67% (13 out of 1930). Suggestions for further improvement include: (1) longer and intensive observation for selected patients before admission; (2) access to early specialist outpatient review; (3) ad-hoc clinics to be run by other specialists for selected “old” cases; and (4) strengthening of the primary health care service.

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Lasserson, Daniel, Christian Subbe, Timothy Cooksley, and Mark Holland. "SAMBA18 Report – A National Audit of Acute Medical Care in the UK." Acute Medicine Journal 18, no. 2 (April 1, 2019): 76–87. http://dx.doi.org/10.52964/amja.0755.

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SAMBA18 took place on Thursday 28th June 2018 with follow up data at 7 days. Acute medical teams from 127 Acute Medical Units (AMUs) across the UK collected data relating to operational performance, clinical quality indicators and standards from NHS Improvement. Data was collected from 6114 patients.

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Welch, Amanda. "Process Mapping Occupational Therapy Activity within a Medical Admissions Unit." British Journal of Occupational Therapy 65, no. 4 (April 2002): 158–64. http://dx.doi.org/10.1177/030802260206500402.

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There are increasing demands on professionals within health care to provide a service that meets the needs and expectations of patients. This requires the patient to be placed at the centre of the care pathway. Occupational therapy is well placed to contribute to this change in emphasis because of its fundamental client-centred philosophy. Experience has shown, however, that the realisation of these aims has been a challenge for all health care professionals. Increasingly, the National Health Service is drawing upon expertise from outside and, in particular, the quality improvement tools that are used within industry. This article explores the use of the traditional quality tool of process mapping in the evaluation and review of occupational therapy processes. The use of this tool is explained in relation to a clinical audit within a medical admissions unit. The results of the process mapping exercise, and the associated audit that was undertaken, demonstrated the value of the approach. In particular, process mapping enabled the occupational therapy service to evaluate systematically the service being provided and to visualise the optimum pathway of care.

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BUDARIN, S. S. "METHODOLOGICAL APPROACH TO EVALUATING THE EFFECTIVENESS OF RESOURCE USE BY MEDICAL ORGANIZATIONS." EKONOMIKA I UPRAVLENIE: PROBLEMY, RESHENIYA 3, no. 7 (2020): 62–69. http://dx.doi.org/10.36871/ek.up.p.r.2020.07.03.007.

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The article reveals methodological approaches to evaluating the effectiveness of the use of resources of medi-cal organizations in order to improve the availability and quality of medical care based on the application of the methodology of performance audit; a methodological approach to the use of individual elements of the efficiency audit methodology for evaluating the performance of medical organizations and the effectiveness of the use of available resources is proposed.

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Mukhortova, Svetlana A., Tatiana V. Kulichenko, Leyla S. Namazova-Baranova, Svetlana G. Piskunova, Elena A. Besedina, and Dmytrij V. Prometnoy. "Audit of the quality of medical care as a way to improve the efficiency of medical organizations." Pediatric pharmacology 14, no. 4 (January 1, 2017): 242–47. http://dx.doi.org/10.15690/pf.v14i4.1755.

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Humphrey, C., and D. Berrow. "Promoting audit in primary care: roles and relationships of medical audit advisory groups and their managers." Quality and Safety in Health Care 4, no. 3 (September 1, 1995): 166–73. http://dx.doi.org/10.1136/qshc.4.3.166.

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Nour A. Sabra, Mohammed. "Cyberthreats on Implantable Medical Devices." Journal of Information Security and Cybercrimes Research 4, no. 1 (June 1, 2021): 36–42. http://dx.doi.org/10.26735/xvjr7905.

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The significant and rapid technological development in the field of medical care, and Implanted Medical Device, clearly lead to improve the quality of care and effectiveness of treatment for numerous diseases that were previously difficult to be controlled. Technological growth has accompanied by a marked fear of academics and researchers during the past ten years from cyber threats that may lead to breaking the goal of creating these devices. Cyberspace risks and threats would expose many patients who use these devices to health complications and then endanger their lives. The risks and the vulnerability of these devices raised the curiosity to search and audit concerns that were purely theoretical and not associated with practical experience. The rapidity of change in the structure of the implanted medical device works as a barrier and reducing the possibility of their exposure to cyber threats. However, create comprehensive policy parallel with raising the awareness of the health care providers are the proactive steps to stop such threats and will be barriers from the cyber threats, therefore, no complete and comprehensive protection from cyberspace threats without ignoring that the Cyber threats will remain in places.

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Shahbaz, Shumaila, and Richard Ward. "QI project: Improvement in quality of Seclusion Medical Review." BJPsych Open 7, S1 (June 2021): S218—S219. http://dx.doi.org/10.1192/bjo.2021.584.

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AimsTo establish the improvements in the quality of seclusion medical review after introducing a template to complete the review.BackgroundThe Mental Health Act – Code of Practice outlines the standards of patient care while in seclusion. It also emphasis that supportive engagement/observation schedules should be reviewed in person and continued at the point an episode of seclusion was initiated.Furthermore, NICE also set up standards to monitor side effect profile while prescribing psychotropic for such patients and regular management review. It also gives importance to staff training to ensure these standards.To improve the quality of the seclusion medical review, we completed an audit in July 2019 to ascertain whether medics are following Trust Policy.We identified good results (above 90%) in the following areas:Time of seclusion reviewRecord keepingManagement planGood documentation of risk, mental state examination and physical health.We also noticed that the following areas can be improved:Prescribed Medications. (60%)Medication side effects. (40%)Physical Observations (40%)We used the following audit standards for our audit after our last audit and a template was designed and after discussion with medics incorporated into the existing documentation template.Time of reviewReason and duration for seclusionPsychiatric diagnosisMental State Examination/BehaviourPhysical health (including physical observations)/EnvironmentMedication (prescribed, rapid tranquilisation, side effects, or adverse effects)Risk (to self-DSH or accidental) (risks to others)Plan :(frequency of physical obs./medical review, management, restrictions, exit plan for terminating seclusion, patient's capacity to understand it)MethodWe considered the following aspects:Retrospective data collection from 01.03.2020 to 30.08.2020.Sample selection: random selection of mixture of clinicians on different times and days of the week.Data analysis was carried out by using Microsoft Excel.ResultWe noticed a marked improvement in the quality of seclusion medical review (between 95% and 100%) after introducing a template for it. There were no major concerns identified during the re-audit.ConclusionTo continue to use the template for Seclusion Medical Review which has shown significant improvement in the quality of the reviews which will improve patient care.It also helped us to deliver person centred care and safe practice.To continue teaching and training of doctors.This QIP project motivated nurses to do an audit on nursing seclusion review and made necessary changes.

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Banik, Debabrata, AK Huda Quamrul, Md Rafayet Ullah Siddique, Md Mizanur Rahman, Md Rezaul Huda, Mohammad Sirajul Islam, and AKM Akhtaruzzaman. "Audit of general intensive care unit of Bangabandhu Sheikh Mujib Medical University." Journal of the Bangladesh Society of Anaesthesiologists 22, no. 1 (February 26, 2014): 12–15. http://dx.doi.org/10.3329/jbsa.v22i1.18095.

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All patients admitted to the Intensive Care Unit of BSMMU between January 2006 and December 2006 on whom data had been entered into the study. A total of 473 admissions with complete records were available. Hospital mortality was 60.6%. Nonsurvivors were older than survivors and had longer ICU stays. Patients admitted from wards had a higher mortality than patients from the operating room/ recovery or the emergency department. Thirty-four percent of patients were in the ICU for >2 days, and they accounted for nearly 81% of bed occupancy. Early identification of patients at risk, both before admission and after discharge from the ICU, may allow treatment to decrease mortality. Research and resources may be best directed at patients who die, despite a relatively low predicted mortality. Many patients die after discharge from ICU and this mortality may be decreased by minimizing inappropriate early discharge to the ward, by the provision of high dependency and step-down units, and by continuing advice and follow-up by the ICU team after the patient has been discharged. DOI: http://dx.doi.org/10.3329/jbsa.v22i1.18095 Journal of BSA, 2009; 22(1): 12-15

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Scott, Ian A. "Audit‐based measures of overuse of medical care in Australian hospital practice." Internal Medicine Journal 49, no. 7 (July 2019): 893–904. http://dx.doi.org/10.1111/imj.14346.

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Chung, CH. "Clinical Audit in Emergency Medicine." Hong Kong Journal of Emergency Medicine 10, no. 3 (July 2003): 181–87. http://dx.doi.org/10.1177/102490790301000308.

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Clinical audit is the review of clinical performance against agreed standards, and the refining of clinical practice as a result – a cyclical process of quality improvement in clinical care. The different steps of the clinical audit cycle are discussed. Publications on clinical audit in connection with Emergency Medicine are scarce in the medical literature. Clinical audit should be made compulsory for all healthcare professionals providing clinical care, and emergency physicians are no exceptions.

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Roy, David. "Setting up district audit meetings in psychiatry." Psychiatric Bulletin 15, no. 7 (July 1991): 417–18. http://dx.doi.org/10.1192/pb.15.7.417.

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Charles Shaw, in a number of articles and his Hospital Handbook (Shaw, 1989, 1990) has played a key role in outlining the principles of medical audit. He arbitrarily divides the process of medical audit into four phases. The philosophical phase which seems to have been negotiated, is whether the medical profession should be involved; the organisational phase; who should lead the process, and the resources required; the practical phase, what should be audited and the methods used; and the invasive phase, how the general concepts and the details of audit are communicated through publication. He goes on to describe a variety of methods of audit including the review of adverse events and general statistics, the assessment of randomly selected records, and finally the review of a topic (which includes medical record review). Another approach in planning audit is through understanding of the organisation itself (Donabedian, 1966) and evaluating quality of care in terms of the structure of the organisation (bricks and mortar, staffing, beds, technology etc.), the process of care, and this may include length of stay, broad out-patients statistics, and perhaps more controversially, face to face contact, group interaction, home visits, day hospital attendance and so on. Finally, and most complex, is outcome.

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Clare, S., and S. Kausar. "Transient Ischaemic Attack Care Pathway." Journal of integrated Care Pathways 11, no. 1 (April 2007): 11–15. http://dx.doi.org/10.1177/205343450701100102.

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A transient ischaemic attack (TIA) is a common medical encounter, which is often managed suboptimally in the acute phase. A TIA should be treated as a medical emergency as studies have shown that high-risk patients can go on to have a stroke within seven days of a TIA. An audit was completed looking at referrals to the TIA clinic. Results prompted the production of a TIA care pathway, which prompted health-care teams on the appropriate management of these patients.

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Mirkes, Sister Renee. "Needed, an Ethics Audit of Catholic Sterilization Policies." Linacre Quarterly 76, no. 2 (May 2009): 163–80. http://dx.doi.org/10.1179/002436309803889287.

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The author proposes an ethics audit of Catholic sterilization policies as a way to correct the disparity between the regnant moral directive prohibiting direct sterilization in Catholic health-care facilities and the policy and practice of allowing tubal ligations for “medical” or “therapeutic” purposes. The proposed four-step plan for the ethics audit involves dialogue and collaboration between U.S. bishops who have Catholic health-care facilities in their dioceses and the respective hospitals’ administration, sponsors, and medical staff. First, bishops clarify for Catholic hospital administrators, sponsors, and system leadership the moral distinction between a direct sterilization and one that is therapeutic or indirect. Second, bishops instruct hospital CEOs to abide by directive 53 of the Ethical and Religious Directives for Catholic Health Care Services by providing only indirect sterilizations. Third, bishops encourage hospital leadership and medical/nursing staff to promote directive 53 in tandem with directive 52 and its call for providing natural family planning services within the hospital. And, fourth, bishops collaborate with the hospital or system leadership in conducting ongoing oversight of sterilization policy/procedures to insure that their Catholic health-care institutions practice durable compliance with directives 52 and 53.

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Journal articles on the topic 'Medical care Medical Audit'

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