Medical audit cycle. A review of methods and research in clinical practice.

The aim of medical audit is to improve the effectiveness and efficiency of medical care. Achieving this aim may involve a cycle of activities: (i) observing practice; (ii) setting a standard of practice; (iii) comparing the observed practice with the standard; (iv) implementing change; and (v) re-observing practice. This paper reviews those methods which have been used and tested in clinical practice at the various stages of the cycle. Some principles involved in the choice of what to audit are also described. As definite cost effective methods of auditing have not yet emerged, further initiatives and experimentation are required in clinical practice.