Objective-To establish what is known about the role of feedback of statistical information in changing clinical practice.Design-Review of 36 studies of interventions entailing the use of statistical information for audit or practice review, which used a formal research design.Subjects-Papers identified from computer searches of medical and health service management publications, of which 36 describing studies of interventions designed to influence clinical care and including information feedback from clinical or administrative data systems were reviewed.Main outcome measures-Evidence for effect of information feedback on change in clinical practice.Results-Information feedback was most likely to influence clinical practice if it was part of strategy to target decision makers who had already agreed to review their practice. A more direct effect was discernable if the information was presented close to the time of decision making. The questions of the optimum layout and quantity of information were not addressed; the 36 papers were insufficient for defining good formats for information to be used for audit or quality assurance.Conclusions-Given the cost of information processing and the current emphasis on closing the audit loop in the health services, it is important that the use of information in the audit process should be critically evaluated.

Objectives:With the implementation of the Mental Health Act 2001 (M HA 2001) in November 2006, there was an expectation of reduction in the overall involuntary admission rate, particularly as those with a sole diagnosis of substance misuse were specifically excluded from the definition of mental disorder. The aim of this audit cycle was to ascertain this rate and to audit the process of the referral, transfer, assessment and subsequent management of the patients whose admission orders were not completed by the consultant psychiatrists (CPs) following referral for involuntary admission to an approved centre. In addition, the authors wished to ascertain if the recommendations of Audit 2003 were implemented.Method:The Audit 2003 analysed all Temporary Patient Reception Orders sent to an approved centre in the year 2003 but whose admission orders were not completed by the CP. A protocol was drawn up to elicit information. The Re-Audit in 2008 used the same protocol. The duration of the Re-Audit was 01.11.06-31.10.07. The results were analysed using SPSS 12.Results:There is no change in the involuntary referral rate to the approved centre in Longford/Westmeath since the new legislation was enacted. The CP continues to refuse to make an order in one in three cases. Patients with a sole diagnosis of alcohol misuse continue to be referred for involuntary admission but are now presenting sober on admission. There also appears to be an increased rate of incorrectly filled forms by GPs.Conclusions:This audit indicates a need for more training for GPs and Gardai in the MHA 2001 and filling of forms.

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