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Completing the audit cycle: The outcomes of audits in mental health services

Lookup NU author(s): Emeritus Professor Senga Bond


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Aims. To assess how far those UK National Health Service mental health settings that tested, and prior to publication, used the Newcastle Clinical Audit Toolkit for Mental Health (NCAT) completed the audit cycle. Data sources. Twelve clinical audit project reports, each focused on one of the five modules in the NCAT, from four rounds of activity over a 2-year period; clinical and managerial staff in the settings where audit projects had taken place. Data extraction. Interviews with audit project team members about the recommendations of the 12 audit project reports and about contextual issues; all projects had reported at least 2 years previously. Results of data synthesis. In analysing the audit project outcomes, five categories of inaction were discernible and five further categories were needed to describe varying states of progress. It was necessary to discriminate between actions attributed to the NCAT audit projects and actions attributed mainly to other initiatives. In total, 26.4% of audit recommendations were still under discussion or in progress. A relatively low proportion of recommendations from audit report findings (34.7%) had been implemented, and these were divided almost equally between recommendations attributed to the NCAT projects (38) and those attributed to other initiatives in the organization (37). Conclusion. Investigation of the medium-term outcomes of clinical audit projects has provided an insight into what might usefully be termed the process of completing the audit cycle. The time-scales required to reach the point at which action is deemed to have been implemented or not may be as long as 3 years. Conceptualizing the action stage of the cycle as a single discrete event fails to do justice to the complexity of the process, and attributing the implementation of change in clinical settings to single causes such as individual audit projects is problematic.

Publication metadata

Author(s): Bond S; Balogh R

Publication type: Article

Publication status: Published

Journal: International Journal for Quality in Health Care

Year: 2001

Volume: 13

Issue: 2

Pages: 135-142

ISSN (print): 1353-4505

ISSN (electronic): 1464-3677

Publisher: Oxford University Press


DOI: 10.1093/intqhc/13.2.135

PubMed id: 11430663


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