Cannell Phillip J
University of Essex, Essex, UK.
Prim Dent Care. 2009 Oct;16(4):168-76. doi: 10.1308/135576109789389522.
A new dental contract was introduced in the National Health Service (NHS) General Dental Services (GDS) in April 2006. Responsibility for clinical audit activities was devolved to Primary Care Trusts (PCTs) as part of their clinical governance remit. In July 2003, an NHS Modernisation Agency pilot scheme for clinical audit was launched by Southend PCT.
The aim of this study was to evaluate this scheme.
A qualitative research method was used. It used audiotape recorded semi-structured research interviews with eight general dental practitioners (GDPs) who had taken part in the scheme. The evaluation focused on dentists' experiences of the scheme.
Dentists appreciated the central PCT-based coordinator for the scheme and found that the streamlining of design, analysis and report writing within the audit projects enabled efficient use of time. The design by an outside agency appeared to add credibility to the scheme. Participants felt that comparability of data derived from clinical audit was enhanced by the scheme and could lead to comparison across PCT patch, regional or even national levels. The use of feedback mechanisms within the scheme was appreciated and thought to help produce maximum value from a clinical audit project. There was evidence of beneficial change occurring within practices and for patients.
This study provided an evaluation of a particular clinical audit scheme, several aspects of which differed from the traditional GDS scheme. Organisations proposing to undertake clinical audit activities in conjunction with dentistry in the future may benefit from incorporating elements of this scheme into their project design.
2006年4月，英国国家医疗服务体系（NHS）的国民牙科服务（GDS）引入了一项新的牙科合同。临床审计活动的责任作为初级医疗信托（PCT）临床治理职责的一部分被下放给了它们。2003年7月，绍森德初级医疗信托发起了一项由NHS现代化机构开展的临床审计试点计划。
本研究旨在评估该计划。
采用定性研究方法。对参与该计划的8名普通牙科医生进行了录音的半结构化研究访谈。评估重点是牙医对该计划的体验。
牙医对该计划以初级医疗信托为核心的协调员表示赞赏，并发现审计项目中设计、分析和报告撰写的简化使得时间得到有效利用。由外部机构进行的设计似乎增加了该计划的可信度。参与者认为，该计划提高了临床审计数据的可比性，并可能促成跨初级医疗信托辖区、地区甚至全国层面的比较。该计划中反馈机制的使用得到赞赏，并被认为有助于从临床审计项目中产生最大价值。有证据表明，诊所内部以及患者身上都发生了有益的变化。
本研究对一项特定的临床审计计划进行了评估，该计划的几个方面与传统的国民牙科服务计划不同。未来打算与牙科联合开展临床审计活动的组织，可能会从将该计划的要素纳入其项目设计中受益。
