Factors influencing audit in general practice

Abstract

Since 1990, the changes introduced in UK general practice, such as fund holding and national incentives, have altered the process of care. Audit, 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 patients", is one method of monitoring change and raising standards. Presents a successful co-ordinated audit in Warwickshire, 1991-1993, involving 53 general practices. Highlights and influence of attitudes and communication within practices on the success of audit strategies. Associates aspects of practice culture, such as team working and decision-making processes with successful audit. Postulates six descriptive practice types, largely related to culture factors. Suggests that if cultural factors within practices are identified, external assistance with audit may be more focused and effective.

Process analysis in general practice ‐ a new perspective?

“…• the validity of the front/back office distinction in general practice and the transfer of knowledge about this from other sectors; • the role of process analysis in developing new views of the operation of small organisations; • the potential for the improvement of processes through improved understanding of the patient/organisation relationship as a result of process analysis. practices, apart from measuring by patient and partner numbers and/or social classification of area, something along the lines of the classification proposed by Davies et al (1996) might be appropriate, considering team function, rate of change, democracy, standards of care and practice tradition. 2 Developing the study to consider other aspects of operations, in particular the improvement aspects.…”