Medical audit in British hospital practice.

The imposition of a rigid system of medical audit throughout the NHS would be inappropriate at this time; nevertheless, every hospital and general practice could usefully consider what informal methods of audit should be employed. Most hospitals should try weekly death and complication meetings in addition to their other postgraduate activities. Greater attention is required to ensure that the medical records are improved in both hospital and general practice. Metcalf's (1979) suggestion for auditing GP work seems feasible. As medicine becomes more complicated in terms of techniques and team activities there is a greater need for more systematic methods of defining and measuring standards of care and feeding back this information. Much more research is needed to determine whether process or outcome studies are preferable, and structure and patient risks must be taken into account. Whatever system is devised the medical profession will accept it provided it is fair, educational, and shown to benefit the patient.