Humphrey C, Berrow D
Department of Public Health and Primary Care, Royal Free Hospital School of Medicine, London.
Qual Health Care. 1993 Dec;2(4):232-8. doi: 10.1136/qshc.2.4.232.
To investigate the approaches to audit of different medical audit advisory groups (MAAGs) and to consider the implications for evaluation of their activities and their developing role in the light of new priorities for clinical audit.
Qualitative study based on semistructured interviews.
15 family health services authority (FHSA) districts in two English health regions.
MAAG chairpersons and support staff and FHSA general managers and medical advisors in each district, totalling 68 subjects.
Structures and activities of MAAGs; perceptions of the MAAG's role and its achievements compared with the initial brief in a health circular in 1990.
The approaches of different MAAGs varied considerably: some concentrated on promoting audit and others were involved in a wider range of development activities. MAAGs assessed their progress in various different ways. The importance of collaborative working was recognised, but few interface audit projects had been undertaken. MAAGs had little contact with other quality assurance activities in the FHSA, and FHSA involvement in the MAAG strategy was variable, although MAAGs were taking steps to improve communication with the FHSA.
Major differences exist in the approaches taken by MAAGs and the roles they fulfil, which will make evaluation of their effectiveness a complex task. Already MAAGs are responding to changing expectations about audit and pressure for closer links with management.
调查不同医疗审计咨询小组(MAAG)的审计方法,并根据临床审计的新重点,考虑对其活动评估及发展作用的影响。
基于半结构化访谈的定性研究。
英国两个卫生区域的15个家庭健康服务管理局(FHSA)辖区。
每个辖区的MAAG主席及支持人员、FHSA总经理和医学顾问,共68名研究对象。
MAAG的结构和活动;与1990年一份卫生通报中的初始简报相比,对MAAG作用及其成就的看法。
不同MAAG的方法差异很大:一些专注于促进审计,另一些则参与更广泛的发展活动。MAAG以各种不同方式评估其进展。协作工作的重要性得到认可,但很少开展界面审计项目。MAAG与FHSA的其他质量保证活动几乎没有联系,FHSA对MAAG战略的参与程度各不相同,尽管MAAG正在采取措施改善与FHSA的沟通。
MAAG采取的方法及其履行的职责存在重大差异,这将使对其有效性的评估成为一项复杂的任务。MAAG已经在回应关于审计的不断变化的期望以及与管理层建立更紧密联系的压力。