Audit of psychiatric discharge summaries: completing the cycle

Clinical audit is regarded as an essential component of clinical governance, which is expected to result in improvements in patient care and to assure trusts that their services meet national quality standards. Several studies have examined the views of health care professionals on clinical audit. An overview by Johnston et al (2000) noted that perceived benefits include improved communication between professional groups and increased professional satisfaction and knowledge, whereas potential disadvantages include diminished clinical ownership, fear of litigation and professional isolation. Although clinical audit should form an essential part of junior doctors’ training, little has been published on the views of the junior doctors who take part in it. A postal survey of junior doctors showed that although 74% of their sample had been involved in audit, a large proportion of projects did not conform to good practice and only 12% carried out a further audit (Greenwood et al, 1997). These findings were echoed in a more recent study which found that often activities that were labelled as ‘audit’ were methodologically poor and that this could produce a negative attitude among junior doctors towards the process (Nettleton & Ireland, 2000). This paper describes an audit completed by a specialist registrar in order to demonstrate the kind of project that can successfully be undertaken by trainees.