Medical Audit and Teaching in Family Medicine, a Before and After Study at Hospital Pedro Vicente Maldonado
Abstract
Objective: To evaluate the intervention of a Medical Audit in a group of postgraduate Family Medicine residents.
Materials and Methods: An exploratory study was carried out, in which a cohort of physicians was evaluated over 6 months. The researchers included 1,060 clinical action reviews and applied the validated on-site medical audit form in Ecuador. The inclusion of cases was initially randomized and subsequently intentional, according to the re-audit processes, to ensure greatest effectiveness.
Results and Discussion: Ambulatory accounts were reviewed primarily. The level of conflict was practically zero; there was acceptance of the medical audit process in a teaching environment; the percentage of appeals was low (less than 0.5%); and cases were presented with high professional maturity and provoked scientific discussion.
The clinical evaluation started with an average quality score of 70% and ended with 88%. Improvements were achieved in almost all fields, especially in non-pharmacological management and active identification and intervention of patient risk. In the legal management of clinical information, a high score (more than 90%) is based on the fact that the forms are electronic and have registration controls.
Conclusions: The observed trend is one of improvement, due to the personalization of interventions by hospital administration and residents.
The acceptance of the process by the residents is high, due to the cooperative, non-punitive approach in an academic context.
These results are encouraging and confirm the validity, effectiveness, and efficiency of the quality assessment and monitoring processes through a comprehensive medical audit in a teaching environment. It is important to emphasize that the process must be continuous to achieve effectiveness of the intervention.
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