The effect of audit and feedback on data recording in the accident and emergency department

J Accid Emerg Med. 1994 Mar;11(1):45-7. doi: 10.1136/emj.11.1.45.

Abstract

Thirteen newly appointed senior house officers (SHOs) at two hospitals were assessed in the recording of two variables: Glasgow Coma Scale (GCS) and diagnostic coding at Hospital A, and GCS at Hospital B. At Hospitals A and B baseline recordings of these variables were established. Active feedback (in the form of data presentation and discussion) was given at 6 and 11 weeks and a final 4-week audit was performed on GCS recordings at 20 weeks. Analysis of GCS recordings of head injuries at Hospitals A and B showed an increase from baseline values of 162/401 (40%) to 336/420 (80%) after feedback 1, and after feedback 2 recordings increased to 379/429 (88%). This was maintained in the last 4-week audit which showed recordings of 220/244 (90%). Further analysis of Hospital A's data showed the SHOs recorded diagnostic coding in 1335/4406 (30%) of cases. After feedback 1, recordings increased to 2550/3327 (77%). After feedback 2 there was no change in recording 2712/3530 (77%). Active feedback improves data recording. The first feedback has a greater impact than the second. Two feedbacks produce a sustained effect in 6 months.

Publication types

  • Comparative Study

MeSH terms

  • Craniocerebral Trauma / diagnosis
  • Emergency Service, Hospital / organization & administration*
  • Emergency Service, Hospital / standards
  • England
  • Feedback*
  • Glasgow Coma Scale*
  • Humans
  • Medical Audit*
  • Medical Records / standards*
  • Medical Staff, Hospital / standards