THE RELATIONSHIP BETWEEN AUDIT, RESEARCH AND POLICY - LESSONS FROM A COMMUNITY PEDIATRIC AUDIOLOGY SERVICE

The pace of medical change is in danger of paralysing the process of d ecision making, particularly in services where clinical improvements o ccur more slowly than the introduction of new interventions. Audit wit hin an individual district enables staff to monitor progress towards d esired goals and standards but rarely generates sufficient data to inf orm decision making about major policy changes. The paper describes ho w the findings from nine audits of a community paediatric audiology se rvice over a 13-year period were combined with reviews of the literatu re, resulting in a series of changes to a children's audiological serv ice. The interest and commitment of all the staff involved were mainta ined by involving them in the process and using them as a valuable sou rce of qualitative data. Audit must be thorough and should be based on precise case definition and comprehensive casefinding if the results are to be meaningful. It is a more powerful means of achieving improve ments in systems if it is combined with research evidence, and a readi ness to change the system if the agreed goals are not being attained.