This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
The points that Dr Hirsch raises are ones commonly expressed by physicians who have not had much actual experience with audit.A low number of deficiencies found was cited. It is important to understand the difference between a deficiency and a variation. Variations from established criteria might include such things as a complication that prolonged hospital stay, a justification for surgery that is legitimate but was not included in the original criteria, or a postoperative death that occurred despite good operative and postoperative management. All of these problems are discussed in detail in each audit, and deficiencies are recorded only when care or judgment were not optimal. In our community, more than 97.5% of all surgical procedures are performed by fully trained surgeons who are board-certified in their specialty in most instances, and we certainly expect and hope that deficiencies in care will be kept at a minimum.
Ashbaugh DG. Audit-Reply. JAMA. 1977;237(7):644. doi:10.1001/jama.1977.03270340029012
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: