临床活动审计:改变临床医生实践的有用工具。

Jo-Anne M Maire
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摘要

持续的专业教育活动,如专业会议和被动的文献传播似乎对改变临床医生的做法没有影响。作为澳大拉西亚脊医和整骨疗法学院持续专业发展项目的一部分,对一组(44名)脊医和整骨治疗师进行了临床活动审核,以确定是否有可能在实践中产生改进。方法:参与者收集了第1轮和第2轮(6个月后)10例患者记录的6项审计标准的相关数据。在完成第一轮测试后,每位参与者都收到了一份关于疼痛和残疾测量的有用临床工具的学习指南。审计标准涉及:用于评估疼痛部位和严重程度的方法,用于评估残疾的方法,进行或命令的其他调查,进行的转诊以及用于疼痛和残疾的结果测量。对数据进行分析,以确定参与者是否在审计过程中增加了对客观疼痛和残疾以及结果测量的使用。结果:将第一轮审计结果与第二轮审计结果进行比较。在第二轮审计中,从业人员对疼痛和残疾的客观测量和结果测量的使用明显更高。结论:临床活动审核是改进临床实践的有效工具。
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CLINICAL ACTIVITIES AUDIT: A Useful Tool for Changing Clinicians' Practice.

Introduction: Continuing professional education activities such as professional conferences and passive dissemination of literature appear to have no little or no impact on changing clinicians' practice. A clinical activities audit was carried out with a group (44) of chiropractors and osteopaths as part of the Chiropractic and Osteopathic College of Australasia's continuing professional development program to determine whether it was likely to generate improvement in practice.Methods: The participants gathered data relating to six audit criteria on ten patient records in round 1 and ten in round 2 (six months later). Each participant received a learning guide relating to useful clinical tools for pain and disability measurement immediately after completing the first round. The audit criteria relate to: methods used to assess the site and severity of pain, methods used to assess disability, other investigations performed or ordered, referrals made and outcome measures used for pain and disability. The data were analysed to determine whether the participants increased their use of objective pain and disability and outcome measures over the course of the audit.Results: Results of the first round of audit were compared with those of the second round. Practitioners' use of objective measures of pain and disability and outcome measures was significantly higher in the second round of audit.Conclusion: This indicates that this clinical activities audit is a useful tool for improving practice.

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