Final Report > Chapter 6: Quality, Standards and Information > Audit

Audit [3]

7 In the 1980s competing ideas about how to assess and improve the quality of care began to emerge, albeit tentatively. Principal amongst these was how to promote `audit' of care. The idea of audit, that clinicians should periodically take time to review and reflect on their practice, to consider what worked well and what did not, and then to `close the audit loop' by making any necessary improvements, was familiar before it became part of any official policy. Healthcare professionals had always had a strong interest in seeking to analyse the outcome of care for their patients. Many doctors participated in some form of review by, for example, holding meetings to consider selected cases. But, there was no structure, far less support in terms of time or resources, for such audit as took place.

8 Moreover, when it was carried out, audit tended to be within professional boundaries. Thus, doctors carried out audit with doctors, nurses with nurses. Further, the extent to which healthcare professionals became involved was a matter for them personally: it depended on their commitment, their enthusiasm and the time available. And, even when they did take part, as we have said, there were no agreed standards to which they could turn to help them evaluate how well they were doing for patients.

Footnotes

[3] We take the term `audit' to mean a systematic framework for assessing care and treatment and for introducing and monitoring improvements