Factors influencing audit in general practice

Since 1990, the changes introduced in UK general practice, such as fund holding and national incentives, have altered the process of care. Audit, defined as “the systematic critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for patients”, is one method of monitoring change and raising standards. Presents a successful co-ordinated audit in Warwickshire, 1991-1993, involving 53 general practices. Highlights the influence of attitudes and communications within practices on the success of audit strategies. Associates aspects of practice culture, such as team working and decision-making processes, with successful audit. Postulates six descriptive practice types, largely related to cultural factors. Suggests that if cultural factors within practices are identified, external assistance with audit may be more focused and effective.