Medical Audit And Quality Management

During the last few years, a number of important developments have had a profound impact on the delivery of health care in India. Perhaps the most important of these to clinicians,administrators and patients, has been the change in societys attitude towards the quality of care that a patient could expect a hospital to deliver. This increased emphasis on the provision of quality health care stems, in a large part, from the increasing number of malpractice and negligence suits against the providers of health care. This also puts additional pressure on the health care organizations and the practicing physicians to evaluate the quality of care provided. Thus, while there is a general agreement on the need of evaluating the health care provided and to conform to the regulations requiring the monitoring of this care, there is a little agreement as to what constitutes quality care or what form evaluation and/or monitoring should take. There are enormous pressures on the health and hospital administrators to deal with a large number of emergencies: political, financial and medical. Within this framework medical professionals are striving for continued improvement of their performance and the highest standards of excellence. Self-evaluation of any degree and of any value is improbable and therefore evaluation by audit and peer review is more likely to achieve its objectives. Medical audit is one component of quality assurance and quality assurance is an essential part of any management process. According to Avedis Donabedian: Professor of Public Health at the University of Michigan, we have granted the health professions access to the most secret and sensitive places in ourselves and entrusted to them matters that touch on our well-being, happiness and survival.