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Annex A > Chapter 18 - Medical and Clinical Audit

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Chapter 18 - Medical and Clinical Audit


Audit: the national perspective

Defining audit

The development of definitions

The national scene: a brief history of audit

Key events

Reactions to the Government's proposals

Creation of the NHS market

The introduction of clinical audit

Changes in funding 1994/95

Clinical effectiveness

The setting of standards

The nature of audit

Types of audit

The effectiveness of the national audit programme

The constraints (if any) placed on confidentiality and/or the assurance of anonymity

International comparisons

Nursing audit

The national context

The Dynamic Standard Setting System (DySSSy)

Evaluation of the nursing and therapy audit programmes

The role of the coroner

The coroner

Records kept by the Home Office

Reports sent to other organisations

`Unnatural death' and `death by natural causes'

Records kept by the Registrar of Births, Marriages and Deaths, and the Office for National Statistics

The South West Region and audit

1988-1990 The Regional Hospital Medical Advisory Committee (RHMAC)

The Bristol Clinical Audit Unit

Effectiveness of the regional audit programme

Audit at district and unit level


1985-1988 The B&WDHA Performance Assessment Committee

The District Audit Committee

The approach of the District to audit after April 1991

The control of audit through the `contracting' process

Monitoring and review of performance by the District

Involvement of the District in nursing audit

Reporting of accidents/incidents

The BRI and the BRHSC pre-1991

The BRI and the BRHSC after 1991

The involvement of management in audit

Devolution of responsibility

Views expressed on the devolutionary approach

Audit committees

Audit co-ordinators and audit assistants

Role of the clinical director

The shift from medical to clinical audit

Collation of audit material by the Audit Committee

Summary of annual Audit Committee reports

Nursing audit in Bristol

Attitudes towards the formal introduction of audit 1990-1993

Views as to the relative responsibility for aspects of audit

Audit of infant and neonatal cardiac surgical services: role and responsibility of the District

The audit and review of the paediatric cardiac surgical services in Bristol

Cardiac surgical audit meetings

Audit meetings, paediatric cardiac surgery and paediatric cardiology

Clinico-pathological meetings

Evening meetings

Other meetings

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