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I agree wholeheartedly with Des Spence - clinical audit travelled
from being ainteresting and useful tool for some to ebing the rod to beat
all into conformity. Likewise risk management tools are taking on the
same "Lord of the Flies" persona. This may be ironic, coming from one who
is a national advocate for clinical audit, but I fear the transition from
gentle persuasion into adoption of this useful tool to the alternative of
conformity as a means of control.
There is no doubt that the medical profession needs to face up to the
significant variation in delivery of even the most basic aspects of
healthcare, and clinical audit is a fantastic tool to halp in this task.
Equally, I find a fundemental missunderstanding of the concept and
practice of clinical audit every day annd most particularly amongst the
more senior medics in the system - the very individuals who are respected
as teachers, mentors and "experts" within healthcare.
So despite, Dr Spence's and my own concerns about audit and other
tools, I think that we need to continue to focus on these practices so
that we can learn both the good and the bad in our practice of clinical