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Friday, February 03, 2006

We Love Audits

This afternoon was Audit Presentation Afternoon.

Audits are good. Audits tell us where we can improve in our clinical practice. Audits lead to more audits which also lead to improvements in clinical practice. Audits are useful tools that help us to see how well we are doing in relation to the gold standards of medical care. Audits are wonderful and have no long lasting side effects. Audits are well-loved by many and are not associated with blinding headaches and insomnia. Audits are not at all time consuming or boring and everybody enjoys them. Hooray for Audits!

*discreet cough*

So every doctor in the department paired up to prepare an audit presentation. There were 7 presentations. They were judged by an International Panel Of Judges (one of our consultants is from Ireland). There was a Glittering Prize for the best presentation (a 500gm gold foil box of Marks & Spencer's Luzury Assorted Swiss Chocolate).

And we won!

Yay for us!

Perhaps it had something to do with the fact that I used Large and Colourful graphics in our presentation. (Who can resist large 3-D pie charts or line graphs in various psychedelic colours? I also had flowcharts! With squiggly arrows! And Venn diagrams! There's nothing more classy than a venn diagram.)

Or the fact that I had a lovely assistant (i.e. my co-presenter) who had on a most attractive short ruffled skirt which went perfectly with her 4 inch tall purple suede shoes.

(P.S. Box of chocolates was grudgingly shared with all the other doctors.)

15 Comments:

Blogger Tym said...

Or maybe you were the only presenters classy enough not to saddle your presentation with all the annoying animation and sounds that afflict so many Powerpoint presentations!

4:13 pm  
Blogger angry doc said...

Audits are good. I love being judged by my ability to alter statistics rather than the real differences I make in patient's lives.

9:07 pm  
Blogger trisha said...

I almost choked on my bak kua when I read "Audits are good". You can't be serious!

Audits in school are the next major killer of trees (after the teachers' printing of worksheets).

And they take us away from doing real meaningful work. We all want to kill the auditor. Yes yes yes!

PS: plus we don't get any prize for a successful audit. Just a formal announcement from the principal and a terse reminder to do well for the next round in 3 years' time. Majorly annoying!

6:44 pm  
Blogger tscd said...

tym: Oooh, actually I wanted to have a sound file of an actual Groan Of Pain. Something like "oooowww I think my leg is broken!". But my partner wouldn't let me put it in.

angry doc: You juggle statistics? You naughty boy! I find it difficult to juggle audit statistics...considering that it's all percentages.

trisha: oh yes, there is nothing I like to do better than shuffle through a few thousand patient casenotes during my free time.

Do you have to do the audit yourself? Or submit data to the auditor? How do you audit teaching?

7:46 pm  
Blogger angry doc said...

Well, put it this way:

Let's say you've got time to make 5 patients out of 10 drop their HbA1c by 1%.

The audit target is 7%.

Will you work on the 5 whose HbA1c are 7-plus percent, or those with 8-plus (or even double digit) percent?

10:15 pm  
Blogger tscd said...

angry doc: I would probably wonder why you only had enough time to work on 5 patients. Your audit cycles are probably not long enough if you don't have enough time to treat all your patients with the same attention - or not long enough to implement changes from the previous audit.

10:40 pm  
Blogger angry doc said...

Just an example, really, but let's narrow it down to one patient:

the patient is 74 years old, not on medication, has a HbA1c of 7.1%, and has no end-organ damage, but still falls within the audit population, do you start him on medication just to push it down for audit's sake?

5:09 pm  
Blogger tscd said...

angry doc: I wouldn't sweat the small stuff when it comes to audit, if that's what you mean. I would treat the patient, not the audit figures. So, no, I wouldn't start the poor man on medication.

Why is he wasting his time coming to my clinic anyway? He should be managed in the community by the GP who is perfectly capable of dealing with an uncomplicated diabetic patient who is diet controlled.

8:22 pm  
Blogger angry doc said...

Ah, I see we are talking about different audits here.

I was talking about audits being used to grade doctors, and you were talking about audits being used to examine the adequacy of the system?

2:27 pm  
Blogger tscd said...

angry doc: Wow you have audits to grade doctors?! That sounds scary. My audits are entirely different, I think. My audits would be like 'How many diabetic patients are getting their HbA1c checked every 6 months?' or 'Door-to-needle times for X condition'.

8:48 pm  
Blogger angry doc said...

It's coming soon - when all medical records are electronic and linked, every doctor will be watched. :)

9:53 am  
Blogger tscd said...

angry doc: Can they really judge you from your medical records? I guess your record keeping will have to be very good. What about things that need to be drawn?

12:31 am  
Blogger angry doc said...

There are audit parameters, like blood pressure, HbA1c, lipid levels, post-op infection rates, re-admission rates, etc.

Many chronic and serious conditions have objective 'measurables' which can be used as 'performance indicators'.

By 2020 all medical records will be electronic and can be assessed centrally.

You can read about it on my blog entry on 09 Jan.

2:50 pm  
Blogger angry doc said...

Hmm... I meant 'accessed', but 'assessed' works too...

5:26 pm  
Blogger tscd said...

angry doc: Big brother is watching you!

9:16 pm  

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