The Royal College of Psychiatrists' Working Party on Medical Audit has emphasised the multidisciplinary nature of patient care in psychiatry (Royal College of Psychiatrists, 1989). Much has been published on individual audit topics and on definitions of the various aspects of audit such as peer review, performance indicators and quality assurance. The essential element of audit is its systematic nature and little has been written concerning an overall structure for clinical audit within an individual psychiatric setting. It is not sufficient to start with ‘a simple project with minimum of cost in terms of both time and money expended’, as recommended by the Royal College of Psychiatrists' Working Party. What is needed is an overall structure for regular review so that the systematic nature of the process is not lost and that recommendations from audit meetings are reviewed regularly for their usefulness and level of implementation.
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