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What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review

Lookup NU author(s): Dr Robbie Foy, Professor Martin Eccles

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Abstract

Background: 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. Methods: We 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. Results: National 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. Conclusion: Audit 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. © 2005 Foy et al; licensee BioMed Central Ltd.

Publication metadata

Author(s): Foy R, Eccles MP, Jamtvedt G, Young J, Grimshaw JM, Baker R

Publication type: Article

Publication status: Published

Journal: BMC Health Services Research

Year: 2005

Volume: 5

Issue: 50

Pages: 7

Print publication date: 13/07/2005

ISSN (electronic): 1472-6963

Publisher: BioMed Central

URL: http://dx.doi.org/10.1186/1472-6963-5-50

DOI: 10.1186/1472-6963-5-50

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