Abstract
BackgroundImproving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care.MethodsWe selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised.ResultsNational guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently.ConclusionAudit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward.
Highlights
Improving the quality of health care requires a range of evidence-based activities
All healthcare systems are concerned with improving the quality of care that they deliver as demonstrated by their establishment of structures (such as the UK NHS National Institute for Clinical Excellence (NICE], the Australian National Institute for Clinical Studies) and high profile reports.[3]
This paper explores the utility of current systematic review evidence to support healthcare system decisions about how to provide evidence based audit and feedback to improve the quality of care by considering it in the context of a common chronic condition and setting – diabetes mellitus in primary care
Summary
Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care. A range of strategies exist to promote the uptake of clinical research findings into the routine care of patients. They seek to change the behaviour of healthcare professionals and thereby improve the quality of patient care (Table 1). For each of these strategies a number of trials of their effectiveness have been drawn together within systematic reviews.[1,2] By examining interventions in a range of (page number not for citation purposes). Across countries clinical audit (hereafter referred to as audit and feedback) is commonly used to both monitor and improve quality of care. [4,5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
